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Pulmonary complications of COVID-19 in premature infants: the reflection of risk factors through imaging investigations
No full textIntroducere. Infecţia COVID-19 a afectat milioane de persoane la nivel global, generând probleme de sănătate pe termen scurt şi lung. Printre grupurile cele mai vulnerabile se regăsesc copii prematuri. Din cauza imaturităţii sistemelor de organe, ei dezvoltă forme severe a bolii şi complicaţii bronhopulmonare. Scop. Scopul studiului a fost evaluarea complicaţiilor bronhopulmonare pe termen lung la copiii prematuri infectaţi cu COVID-19, utilizând metode imagistice, în special computer tomografie pulmonară. Material şi metode. Studiul a fost realizat în Clinica de Pneumologie Pediatrică a Institutului Mamei şi Copilului, pe o perioadă de 3 ani (2021-2024). Eşantionul a inclus 101 copii, împărţiţi în funcţie de vârsta gestaţională, care au fost examinaţi prin Tomografie Computerizata (CT) pulmonară pentru a evalua efectele infecţiei COVID-19 asupra plămânilor. Rezultate. Conform datelor CT, modificări patologice pulmonare au fost identificate la 72 de copii (71,29%; IC 95%: 61,8179,2) în timp ce 29 de copii (28,71%; IC 95%: 20,8-38,19) au avut un aspect pulmonar normal. Dintre aceştia, 12 copii prematuri (16,6%) au prezentat modificări imagistice pulmonare, cu o vârstă gestaţională medie de 31,25 săptămâni. Predominanţa a fost observată la sexul masculin. În grupul prematurilor care au suportat infecţia COVID-19, 50% au prezentat modificări pneumofibrotice, 40% copii au avut bule de aer subcentimetrice, iar în 25% cazuri s-au identificat aderenţe pleuro-pulmonare, indicând procese inflamatorii persistente. Concluzii. Copiii născuţi prematur care au fost infectaţi cu virusul SARS-CoV-2, sunt expuşi unui risc semnificativ de a dezvolta complicaţii bronhopulmonare pe termen lung. Vârsta gestaţională şi sexul masculin se corelează negativ cu frecvenţa modificărilor imagistice patologice.Introduction. COVID-19 infection has affected millions of people globally, with both short- and long-term effects. Among the most at-risk are preterm infants, due to immature organs and immune systems, making them prone to severe disease evolution and persistent over time bronchopulmonary complications. Objective. This study aimed to assess long-term bronchopulmonary complications in preterm infants diagnosed with COVID-19, using imaging methods, especially pulmonary computed tomography scans. Material and methods. This study was conducted at the Pediatric Pulmonology Clinic of the Mother and Child Institute from Moldova, over three years (2021-2024). A total of 101 children, classified by gestational age, underwent chest computed tomography scans to evaluate lung damage caused by COVID-19 infection and identify possible long-term effects. Results. Computed tomography (CT) scans revealed pulmonary changes in 72 children (71.29%; 95% CI: 61.81-79.2), while 29 (28.71%; 95% CI: 20.838.19) had normal lung images. Among them, 12 preterm infants (16.6%) with an average gestational age of 31.25 weeks showed pathological radiological changes. A male predominance was observed in this study. Of the preterm infants who had COVID-19 infection, fifty percent exhibited pneumofibrotic lesions, forty percent had subcentimeter air cysts, and twenty-five percent presented pleuro-pulmonary adhesions, suggesting persistent inflammatory processes even after the acute phase of infection. Conclusion. Preterm infants infected with SARS-CoV-2 are at high risk for longterm bronchopulmonary complications. Male sex and lower gestational age were associated with more frequent pathological findings, highlighting the importance of long-term imaging follow-up in this population
Left atrial myxoma with severe mitral obstruction and sinus dysfunction: diagnostic and therapeutic challenges in a complex case
No full textIntroducere. Tumorile cardiace primare sunt entităţi rare, cu potenţial sever hemodinamic şi embolic. Mixomul atrial, deşi benign histologic, poate induce obstrucţii intracavitare semnificative şi aritmii, necesitând diagnostic precoce prin metode imagistice non-invazive şi intervenţie chirurgicală rapidă. Scop. Prezentarea unui caz de mixom atrial stâng cu manifestări severe, diagnosticat prin ecocardiografie şi tratat chirurgical, evidenţiind necesitatea colaborării multi-disciplinare. Material şi metode. Pacientul Ţ. S., 58 ani, fără antecedente cardiace cunoscute, se prezintă pentru dispnee la efort moderat, instalată de aproximativ o lună, asociată cu slăbiciune generală. Ecocardiografia depistează o formaţiune mobilă 53x46 mm în atriul stâng, cu obstrucţie mitrală, regurgitare valvulară severă şi hipertensiune pulmonară severă. Rezultate. S-a practicat înlăturarea formaţiunii de volum din atriul stâng, plastia complexă a valvei mitrale, an-uloplastia de valvă tricuspidă şi suturarea urechiuşei atri-ului stâng. În perioada postoperatorie, pacientul prezintă tendinţă spre bradicardie severă. Monitorizarea continuă Holter ECG depistează boala de nod sinusal cu 31 pauze mai lungi de 3,4 secunde, pauza cea mai lungă fiind de 3,8 secunde în perioada de veghe. S-a implantat stimulator cardiac bicameral Enticos 4 DR, cu evoluţie favorabilă, fără complicaţii. Cazul reflectă potenţialul de deteriorare rapidă şi complexitatea managementului în tumorile cardiace aparent benigne. Concluzii. Mixomul atrial poate fi asimptomat-ic, însă în funcţie de dimensiune şi localizare poate provoca complicaţii severe. Diagnosticul ecocardiografic precoce şi tratamentul chirurgical rapid sunt esenţiale pentru prevenirea decompensării hemodinamice, complicaţiilor embolice şi aritmiilor.Introduction. Primary cardiac tumors are rare entities with potentially severe hemodynamic and embolic effects. Atrial myxoma, though histologically benign, can induce significant intracavitary obstruction and arrhythmias, requiring timely diagnosis through non-invasive imaging and urgent surgical intervention. Objective. To present a case of left atrial myxoma with severe clinical manifestations, diagnosed by echocardiography and surgically treated, emphasizing the need for rapid multidisciplinary collaboration. Material and methods. Patient T. S., 58 years old, with no known cardiac history, presented with moderate exertional dyspnea progressively installed over the past month, associated with general weakness. Echocardiography revealed a mobile 53x46 mm mass in the left atrium, causing mitral obstruction, severe valvular regurgitation, and severe pulmonary hypertension. Results. Surgical intervention involved resection of the left atrial mass, complex mitral valve repair, tricuspid valve annuloplasty, and closure of the left atrial appendage. In the postoperative period, the patient exhibited a tendency toward severe bradycardia. Continuous ECG Holter monitoring revealed sick sinus syndrome with 31 pauses exceeding 3.4 seconds, the longest reaching 3.8 seconds during wakefulness. A dual-chamber pacemaker (Enticos 4 DR) was implanted, with favorable evolution and no complications. This case highlights the potential for rapid clinical deterioration and the complexity of management in seemingly benign cardiac tumors. Conclusion. The atrial myxoma may remain asymptomatic, however, depending on its size and location, it can lead to severe complications. Early diagnosis through echocardiography and prompt surgical intervention are essential to prevent hemodynamic decompensation, embolic events, and arrhythmias
LAPAROSCOPIC LATERAL HYSTEROPEXY USING DUBUISSON'S METHOD IN THE TREATMENT OF PELVIC ORGAN PROLAPSE
No full textUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Prolapsul organelor pelvine reprezintă o anomalie de statică pelviană, are o incidenţă de 50% în rândul femeilor multipare, iar necesitatea corecţiei chirurgicale depăşeşte 11%. Se datorează slăbirii aparatului de susţinere sau suspensie a organelor şi este asociat cu dereglări urinare, digestive, sexuale. Scop. Interpretarea aspectelor tehnice chirurgicale, indicaţiilor, complicaţiilor şi gradului de satisfacţie a pacientelor operate prin metoda Dubuisson pentru prolapsul de organe genitale. Material şi metode. În cadrul acestui studiu s-a realizat o sinteză a literaturii de specialitate, care a inclus articole publicate în anii 2020-2025. Bazele de date utilizate au fost: PubMed, ScienceDirect, Cochrane Database, Google Scholar, UptoDate, folosind cuvintele-cheie «prolapsul organelor genitale, histerosuspensia laterală laparoscopică, colporafia». Rezultate. Histeropexia laterală laparoscopică, descrisă de Dubuisson, este o tehnică modernă de fixare a meşei sintetice la peretele vaginal anterior, capetele libere trecute retroperitoneal şi ataşate la peretele abdominal lateral, păstrând structura anatomică şi funcţionalitatea aparatului genital. Indicaţii: prolaps vaginal anterior şi apical. Majoritatea complicaţiilor raportate vizează erozia meşei. Comparativ cu sacrocolpopexia, riscul leziunilor vasculare, nervoase, viscerale este minim, întrucât permite suspendarea uterului fără a recurge la histerectomie sau ancorare la promontoriul sacral. Gradul de satisfacţie a pacientelor este peste 90%. Concluzii. Metoda Dubuisson se conturează ca o alternativă sigură şi eficientă în tratamentul prolapsului organelor pelvine, cu puţine complicaţii majore şi îmbunătăţirea considerabilă a calităţii vieţii. Este oportună pentru pacientele care îşi doresc păstrarea uterului şi o abordare minim invazivă.Introduction. Pelvic organ prolapse is a disorder of pelvic statics, affecting up to 50% of multiparous women, with other 11% requiring surgical correction. It results from the weakening of the pelvic support or suspension structures and it is associated with urinary, digestive, and sexual dysfunctions. Objective. The aim of the study is to interpret aspects of the surgical technique, indications, complications and patient satisfaction following the Dubuisson method for genital prolapse. Material and methods. This research is a literature review, that includes scientific articles published between 2020 and 2025. The databases used for this purpose were: PubMed, ScienceDirect, Cochrane Database, Google Scholar, UptoDate, on the following keywords “genital organ prolapse, lateral laparoscopic hysterosuspen-sion and colporrhaphy”. Results. Laparoscopic lateral hysteropexy, described by Dubuisson, is a modern technique of fixing a synthetic mesh to the anterior vaginal wall, with the free ends passed retroperitoneally, anchored to the lateral abdominal wall, while preserving the anatomical integrity and function of the genital organs. Indications: anterior and apical vaginal prolapse. Most of the reported complications concern mesh erosion. Compared to sacrocolpopexy, the risk of vascular, nerve, visceral injuries is minimal, as it allows the suspension of the uterus without hysterectomy or anchoring to the sacral promontory. The degree of patient satisfaction is over 90%. Conclusion. The Dubuisson method proves to be a safe and effective alternative for treating pelvic organ prolapse, with a low rate of major complications and significant improvement in quality of life. It is suitable for patients who wish to preserve the uterus and opt for a minimally invasive approach
The particularities of the actual dietary intake of patients with kidney disease
Full text linkIntroduction. The prevalence and mortality associated with kidney diseases are
increasing, reaching an estimated 700–850 million cases worldwide. Kidney diseases
represent a significant public health concern in the Republic of Moldova as well. Among the
factors that can influence kidney health, diet plays an important role.
Purpose of the study. This study aimed to examine and assess the actual dietary patterns
of patients with kidney diseases. Research objectives: 1) to assess the real diet of patients
with kidney diseases using a questionnaire method; 2) to evaluate the results obtained;3) to
develop practical recommendations.
Material and methods. The study included 101 patients admitted to the specialized
department of "Timofei Moșneaga" Republican Clinical Hospital. The research used
sociological, statistical, and hygienic methods. A questionnaire consisting of 40 questions
was used.
Results. The study sample included 73.3% women and 26.7% men, of whom 63.3% were
from rural areas and 36.7% from urban areas, aged between 20 and 84 years. The mean
Body Mass Index was 28.6 kg/m². Most participants (55.6%) reported eating three times
daily, while 23.2% ate four times daily. Salty and spicy foods were preferred by 60.6% of
respondents. Alcohol consumption was reported by 40.6%, with wine being the most
commonly consumed beverage. Bread consumption was moderate (2–4 slices per day), and
white bread was preferred by 46.53% of respondents. Milk and dairy products were
consumed by 80.2% of participants, and meat and meat products were widely consumed;
only 1.98% did not eat them daily, 41.9% consumed them once a day, and the remainder 2–
3 times daily. Fish consumption was considerably lower, with 48.9% eating fish once a week
and 22.7% twice a week. Two to three types of vegetables were consumed daily by 60.4% of
participants, while fruits were eaten daily by approximately half of them. Among beverages
consumed with meals, tea was most frequent, whereas water predominated between meals.
The total daily fluid intake was 1–1.5 L in 35.7% of cases, 2 L in 29.6%, 2–2.5 L in 23.5%,
and up to 1 L in 8.2%. A total of 72.7% of respondents reported adding salt to their food at
each meal. Fast food was preferred mainly by men. Food supplements were used by 25.7%
of participants. Awareness of various risk factors for kidney diseases ranged between 18.8%
and 53.1%. Health promotion activities addressing this topic were reported to exist in their
local communities by 45.5% of respondents.
Conclusions. Several unhealthy eating behaviors were identified, and only 45.54% of
patients participated in health promotion programs. Accordingly, specific practical
recommendations were proposed
Fatal familial insomnia: impact of the D178N prion protein mutation on thalamic nuclei degeneration and neurological symptoms
Full text linkIntroducere. Insomnia familială fatală (IFF) este o boală neurodegenerativă rară, fatală, cauzată de mutaţia D178N în PRNP cu metionină la codonul 129. Afectează selectiv nu-cleii talamici, provocând insomnie progresivă, disfuncţie autonomă şi declin cognitiv sever. Studiul detaliază mecanismele moleculare ale bolii. Scop. Studiul vizează analizarea mecanismului molecular al IFF cauzat de mutaţia D178N PRNP şi evaluarea efectelor degenerative asupra nucleilor talamici, corelând aceste modificări cu simptomele clinice. Material şi metode. Au fost analizate 15 articole ştiinţifice relevante publicate între 2014 şi 2024 din bazele de date PubMed şi ScienceDirect. Lucrările includ cazuri familiale, cercetări genetice, imagistică şi analize histopatologice axate pe acumularea proteinei prion patologice (PrPASc) şi leziuni talamice. Studiile fără date genetice au fost excluse. Rezultate. Mutaţia D178N cu metionină la codonul 129 în PRNP transformă proteina prion normală (PrPAC) în forma patologică PrPASc. PrPASc se acumulează în nucleii talamici mediodorsali şi anteroventrali, provocând glioză şi pierdere neuronală fără plăci amiloide. Studiile PET arată hipome-tabolism talamic precoce, corelat cu insomnie severă, tulburări autonome (hiperhidroză, tahicardie), halucinaţii şi declin cognitiv rapid. Debutul apare în jurul vârstei de 50 de ani, cu progresie fatală în 6-36 luni. Rezultatele confirmă o legătură strânsă între afectarea talamusului şi tabloul clinic specific. Aceste descoperiri diferenţiază IFF de alte boli prionice. Concluzii. IFF exemplifică neurodegenerarea genetică unde mutaţia D178N cauzează leziuni talamice selective şi progresie fatală rapidă. Diagnosticul genetic precoce şi consilierea familială sunt cruciale, deoarece nu există tratament curativ. Studiile viitoare pot permite terapii ţintite.Introduction. Fatal familial insomnia (FFI) is a rare, fatal neurodegenerative disease caused by the D178N mutation in the PRNP with methionine at codon 129. It selectively affects thalamic nuclei, causing progressive insomnia, autonomic dysfunction, and severe cognitive decline. The study details the molecular mechanisms. Objective. This study aims to analyze the molecular mechanism of FFI caused by the D178N PRNP mutation and assess its degenerative effects on thalamic nuclei, correlating these changes with the clinical symptom. Material and methods. 15 relevant scientific articles published between 2014 and 2024 were reviewed from PubMed and ScienceDirect databases. Papers included familial cases, genetic research, imaging, and histopathological analyses focusing on pathological prion protein (PrPASc) accumulation and thalamic damage. Studies lacking genetic data were excluded. Results. The D178N mutation with methionine at codon 129 in PRNP converts normal prion protein (PrPAC) into pathological PrPASc. PrPASc accumulates in mediodorsal and anteroventral thalamic nuclei, causing gliosis and neuronal loss without amyloid plaques. PET studies show early thalamic hypome-tabolism, correlating with severe insomnia, autonomic disturbances (hyperhidrosis, tachycardia), hallucinations, and rapid cognitive decline. Onset typically occurs around age 50, with fatal progression within 6-36 months. These findings confirm the close link between thalamic damage and clinical picture. These results distinguish FFI from other prion diseases. Conclusion. FFI exemplifies genetic neurodegeneration where the D178N mutation causes selective thalamic damage and rapid fatal progression. Early genetic diagnosis and family counseling are crucial, as no curative treatment exists so far. Future studies may enable targeted therapies
Effects of abiotic stress on bioactive compounds from the Galium and Helichrysum: a perspective on antioxidant capacity
Full text linkMulțumiri
Această lucrare a fost finanțată printr un grant al Autorității Naționale
pentru Cercetare Științifică din România, CNCS – UEFISCDI, proiect nr.
PN IV P8 8.3 ROMD 2023 0022.
Acknowledgement
This work was supported by a grant from the Romanian National Authority
for Scientific Research, CNCS – UEFISCDI, project number PNIV-
P8-8.3-ROMD-2023-0022.Introducere. Plantele din genurile Galium şi Helichrysum sunt apreciate pentru proprietăţile lor farmacologice şi utilizări medicinale tradiţionale. Acestea stimulează producţia de compuşi bioactivi (polifenoli şi flavonoide) sub stres abiotic, protejând celulele şi contribuind la mecanismele de apărare ale plantelor. Scop. Acest studiu urmăreşte să investigheze modul în care condiţiile abiotice, cum ar fi seceta, inundaţiile şi ozonul, influenţează proprietăţile biochimice ale plantelor medicinale. Material şi metode. Pentru fiecare specie de Galium şi Helichrysum, frunzele mature au fost prelevate din lotul-martor şi după trei tratamente de stres abiotic. Conţinutul de flavonoide şi polifenoli totali a fost măsurat prin metoda spectrofotometrica. Activitatea antioxidantă a fiecărui extract a fost măsurată simultan prin DPPH, ABTS, FRAP şi CUPRAC. Rezultate. Stresul abiotic moderat a stimulat acumulările fenolice şi flavonoidice: polifenolii totali au crescut cu 30-60 % faţă de martor, în special sub deficit hidric în timp ce stresul sever determină scăderea concentraţiilor, indicând depăşirea capacităţii de adaptare. Capacitatea antioxidantă (determinată prin metodele CUPRAC, DPPH, FRAP si ABTS), a sporit cu 35-50 %, extractele din plante deshidratate atingând valorile maxime. Concentraţiile de polifenolii s-au corelat strâns cu capacitatea antioxidantă, iar creşterea concentraţiilor de flavonoide explică creşterea suplimentară în activitatea antioxidantă de 10-15 % din variaţia totală. Concluzii. Stresul abiotic moderat, precum seceta, inundaţiile şi fumigatia cu ozon, creste producţia de polifenolii şi flavonoidele în genurile Galium şi Helichrysum, îmbunătăţind activitatea antioxidantă. Stresul sever scade aceste valori, depăşind capacitatea plantelor de adaptare.Introduction. Plants of the genera Galium and Helichrysum are valued for their pharmacological properties and traditional medicinal uses. They stimulate the production of bioactive compounds (polyphenols and flavonoids) under abiotic stress, protecting cells and contributing to plant defense mechanisms. Objective. This study aims to investigate the ways in which abiotic conditions, such as drought, flooding, and ozone, influence the biochemical properties of medicinal plants. Material and methods. For each species of Galium and Helichrysum, mature leaves were sampled from the marker batch and after three abiotic stress treatments. Total flavonoids and polyphenols content was measured by spectrophotometric method. The antioxidant activity of each extract was measured simultaneously by DPPH, ABTS, FRAP and CUPRAC. Results. Moderate abiotic stress stimulated phenolic and flavonoid accumulations: total polyphenols increased by 30-60 % compared to the control, especially under water deficit while severe stress caused a decrease in concentrations, indicating an overcoming of the adaptive capacity. Antioxidant capacity (determined by CUPRAC, DPPH, FRAP and ABTS methods), increased by 35-50 %, with extracts from dehydrated plants reaching maximum values. Concentrations of polyphenols correlated closely with antioxidant capacity, and the increase in flavonoid concentrations explained the additional increase in antioxidant activity of 10-15 % of the total variation. Conclusion. Moderate abiotic stress, such as drought, flooding and ozone fumigation, increases the production of polyphenols and flavonoids in the genera Galium and Helichrysum, enhancing antioxidant activity. Severe stress decreases these values, exceeding the plants' capacity to adapt
Evaluation of excissional treatment of precancerous cervical lesions
Full text linkIntroducere. Leziunile precanceroase ale colului constituie un factor major de risc pentru dezvoltarea cancerului cervical, iar tratamentul adecvat al acestor leziuni sunt fundamentale pentru prevenirea formelor invazive. Evaluarea eficacităţii tratamentului excizional este crucială pentru reducerea riscului de recurenţă. Scop. Evaluarea eficacităţii tratamentului excizional al leziunilor precanceroase de col uterin, reiesind din marginile chirurgicale dupa procedura LEEP şi testele citologice de monitorizare peste 6 luni. Material şi metode. A fost efectuat un studiu retrospectiv care a inclus 975 femei evaluate colposcopic în cadrul Centrului de referinţă în colposcopie IMC în perioada 2019-2021. În 204 cazuri a fost confirmată displazia severă, pentru care s-a efectuat procedura de excizie larga a zonei de transformare (LEEP). S-au analizat histopatologic marginile de rezecţie. Rezultate. Excizia completă a fost obţinută în 78,33% cazuri, iar în 21,66% au fost identificate margini implicate precum cea endocervicală - în 62,35%, ectocervicală - în 25,88%, iar marginea profundă în 11,76%. Implicarea marginii endocervicale sugerează extensie în endocervix. Tactica ulterioară a reiesit din vârsta pacientei şi particularităţile histopatologice ale leziunii. Pacientele de până la 45 ani au fost monitorizate citologic peste 6 luni, cu rezultat NLIM în 87,3%, iar in 17,7% cazuri a necesitat LEEP repetat. La cele de peste 45 ani s-a recurs la LEEP repetat în 56% nefiind detectate careva remenescenţe de leziune. Concluzii. Tratamentul excizional s-a dovedit eficient în circa 3/4 dintre cazuri, fiind o metodă importantă în prevenţia cancerului cervical invaziv. Implicarea marginilor chirurgicale de excizie, mai ales a celei endocervicale, impune optimizarea tehnicii şi monitorizarea pacientelor în dinamică.Introduction. Cervical precancerous lesions represent a major risk factor for the development of cancer. Appropriate treatment of these lesions are fundamental in preventing of invasive forms. Evaluation of the effectiveness of exci-sional treatment is crucial for optimizing management and reducing the risk of recurrence. Objective. To assess the effectiveness of excisional treatment of cervical precancerous lesions based on surgical margins in patients after the LEEP procedure and cytological follow-up tests after 6 months. Material and methods. A retrospective study was conducted on 975 women examined colposcopic at the Colposcopy Reference Center of IMC during the period 2019-2021. In 204 cases, severe dysplasia was confirmed, and large excision of the transformation zone (LEEP) was performed. His-topathological analysis of the resection margins was carried out. Results. Complete excision was achieved in 78.33% of cases, while in 21.66% margins were identified as involved, such as the endocervical margin - in 62.35%, ectocervical margin - in 25.88%, and deep margin in 11.76%. Involvement of the endocervical margin suggests extension into the endocervix. The subsequent tactic was based on the patient's age and the histopathological characteristics of the lesion. Patients up to 45 years old were monitored cytolog-ically after 6 months, with an NLIM result in 87.3%, while in 17.7% of cases repeat LEEP was required. In those over 45 years old, repeat LEEP was performed in 56%, with no residual lesions detected. Conclusion. Excisional treatment has proven effective in about 3/4 of cases, being an important method in the prevention of invasive cervical cancer. The involvement of surgical excision margins, especially the endocervical one, requires optimization of the technique and dynamic monitoring of patients
Post-cycle therapy and male hypogonadism after androgen misuse. Is there a pharmacological basis for this?
Full text linkUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Utilizarea abuzivă a androgenilor de către bărbaţii tineri şi adolescenţii care doresc să obţină o creştere rapidă a masei musculare poate produce ASIH (anabolic steroid induced hypogonadism - hipogonadism indus de steroizi anabolizanţi) cu infertilitate cauzată de inhibiţia axului hipotalamo-hipofizar. Scop. A fost creat un model animal (şobolan) al riscurilor abuzului de androgeni asupra fertilităţii în scopul evaluării medicaţiei post-ciclu asupra calităţii lichidului seminal şi comportamentului sexual. Material şi metode. S-au evaluat pe modelul animal antiestro-geni, modulatori selectivi ai receptorilor pentru estrogeni şi inhibitori de aromatază. În practică aceştia sunt utilizaţi ca terapie post-ciclu, deşi nu au indicaţie oficială la bărbaţi, iar utilizarea lor în practica clinică este „off-label”. În plus, sunt medicamente interzise de codul antidoping. Rezultate. Rezultatele obţinute experimental confirmă raportările de cazuri din patologia iatrogenă autoindusă de consumatorii de androgeni şi steroizi anabolizanţi. Întrucât utilizarea este ilicită nu este posibilă efectuarea unui studiu clinic în acest scop. Modelul animal indică că utilizarea inhibitorilor de aromatază reduce efectele nocive ale abuzului androgenic (testosteron undecanoat i.m, pe termen lung, echivalentul unei supradoze umane utilizate în dopaj), împiedică oligospermia, dar nu corectează în totalitate alţi parametri (astenospermia, morfologia spermatozoilor) şi influenţează în mod negativ comportamentul prospectiv faţă se sexul opus. Concluzii. Terapia post-ciclu are ca scop diminuarea consecinţelor endocrine ale abuzului de androgeni (infertil-itate, inhibarea axului hipotalamo-hipofizar). Deşi acest risc scade, efectele nocive nu sunt complet reversibile: libidoul şi comportamentul sexual sunt influenţate negativ conform modelului animal.Introduction. The misuse of androgens by young men and adolescents who want to achieve rapid muscle mass growth are prone to developing anabolic steroid-induced hypogonadism (a disease which is particularly known as ASIH). One of the consequences is infertility caused by inhibition of the hypothalamic-pituitary axis. Objective. An animal (rat) model of the risks of androgen abuse on fertility was created to evaluate the post-cycle medication used by athletes on sperm quality and sexual behavior. Material and methods. Antiestrogens, selective estrogen receptor modulators, and aromatase inhibitors have been evaluated in the aforementioned animal model. In practice, they are used as post-cycle therapy, although they have no official indication in men, and their use in clinical practice is “off-label”. In addition, they are drugs prohibited by the anti-doping code. Results. Experimental Results. confirm case reports of self-induced iatrogenic pathology in users of androgens and anabolic steroids. Since the use is illicit, it is not possible to conduct a clinical trial for this purpose (due to ethical concerns). The animal model indicates that the use of aromatase inhibitors reduces the harmful effects of androgen abuse (i.m. testosterone undecanoate, long-term, equivalent to a human overdose used in doping), prevents oligospermia, but does not completely correct other parameters (asthenospermia, sperm morphology) and negatively influences prospective behavior towards the opposite sex. Conclusion. Post-cycle therapy aims to reduce the endocrine consequences of androgen abuse (infertility, hypothalamic-pituitary axis inhibition). Although this risk decreases, the harmful effects are not completely reversible: libido and sexual behavior are negatively influenced according to our animal model
The rate of progression of chronic kidney disease based on etiology
Full text linkUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Boala cronică de rinichi (BCR) evoluează în ritmuri diferite, în funcţie de etiologie: nefropatia diabetică, nefroscleroza hipertensivă, glomerulonefrita şi boala polichistică renală. Prezenţa proteinuriei şi hipertensiunii accelerează declinul funcţiei renale şi riscul stadiului final al bolii. Scop. Scopul lucrării este să compare ratele de progresie ale bolii cronice de rinichi pe categorii etiologice şi să identifice factorii clinici de risc care influenţează declinul funcţiei renale. Material şi metode. S-a efectuat o revizuire sistematică a studiilor publicate între 2015 şi 2025 în PubMed, Scopus şi Web of Science. Au fost incluse studii clinice şi cohorte prospective în limba engleză care raportau ratele de progresie ale BCR după etiologie. Doi evaluatori independenţi au extras date despre declinul eGFR şi factorii de risc. Rezultate. Analiza literaturii de specialitate a evidenţiat diferenţe importante în ritmul de progresie al bolii cronice de rinichi în funcţie de etiologie. Nefropatia diabetică şi boala polichistică renală au fost asociate cu cel mai rapid declin al eGFR, urmate de glomerulonefrită. Nefroscleroza hipertensivă a avut cea mai lentă evoluţie. Proteinuria, hipertensiunea arterială, vârsta avansată, sexul masculin şi comorbidităţile cardiovasculare au fost frecvent implicaţi în agravarea progresiei. Studiile susţin că diagnosticul etiologic precoce şi tratamentele adaptate etiologiei pot întârzia semnificativ progresia spre stadiul terminal. Concluzii. Identificarea timpurie a etiologiei bolii cronice de rinichi este crucială pentru estimarea corectă a ritmului de progresie şi alegerea unui tratament eficient. Abordările terapeutice adaptate pot reduce complicaţiile, întârzia stadiul final şi îmbunătăţi supravieţuirea renală.Introduction. Chronic kidney disease (CKD) progression varies by etiology: diabetic nephropathy, hypertensive nephrosclerosis, glomerulonephritis and polycystic kidney disease. Proteinuria and hypertension accelerate renal decline and ESRD risk. Early etiologic diagnosis and risk stratification guide personalized therapy. Objective. The aim of this study is to compare progression rates of chronic kidney disease across etiologies and to identify clinical risk factors that influence decline in renal function. Material and methods. systematic review of studies published between 2015 and 2025 in PubMed, Scopus, and Web of Science was conducted. English-language clinical and prospective cohort studies reporting CKD progression rates by etiology were included. Two independent reviewers performed study selection and extracted data on eGFR decline and associated risk factors. Results. The systematic review of the literature revealed important differences in the rate of progression of chronic kidney disease, depending on its underlying etiology. Diabetic nephropathy and polycystic kidney disease were linked to the most rapid decline in eGFR, followed by glomerulonephritis. Hypertensive nephrosclerosis progressed more slowly. Proteinuria, high blood pressure, older age, male sex, and cardiovascular comorbidities were frequently associated with disease worsening. Studies emphasize that early etiological diagnosis and specific treatment strategies can help delay progression to endstage renal disease. Conclusion. Identifying the etiology of CKD early is essential for predicting its rate of progression and guiding appropriate therapy. Etiology-based interventions can reduce complications, delay the onset of end-stage renal disease, and improve long-term clinical and functional outcomes
CLINICO-STATISTICAL EVALUATION OF MANDIBULAR FRACTURES
Full text linkUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Fractura de mandibulă este frecvent întâlnită în practica stomatologică, având o clinică variată din cauza mobilităţii mandibulei, prezenţei arcadelor dentare şi a inserţiei muşchilor mobilizatori. Aceste particularităţi complică diagnosticarea şi tratamentul, iar adresarea tardivă cauzează complicaţii grave. Scop. Studierea dinico-statis-tică a pacienţilor cu fractură de mandibulă, în cadrul IMU, în perioada anului 2024, pentru a analiza frecvenţa cazurilor, complicaţiile şi tratamentele utilizate. Material şi metode. Studiu retrospectiv, analitic ce include 107 pacienţi cu fractură de mandibulă, internaţi în secţia de Chirurgie OMF din IMU în 2024Aprecierea indicatorilor a fost realizată prin fişa medicală care includea următoarele criteriile: vârstă, sex, metoda de tratament utilizată (ortopedică sau chirurgicală). Statistica: Microsoft Office Excel. Rezultate. Reieşind din studiul efectuat, în 2024 fracturile de mandibulă au alcătuit 5,7% din numărul total de pacienţi internaţi. Au fost afectaţi frecvent bărbaţii- 92,5% cu vârsta între 20-40 de ani (57% din toate cazurile) fiind apţi de muncă. Femeile constituie 7,47%. Pacienţii internaţi cu fracturi recente şi trataţi prin metoda ortopedică (imobilizarea mandibulei prin aplicarea atelelor bimaxilare) reprezintă 61%. Metoda chirurgicală, de imobilizare prin osteosinteză, s-a utilizat în 29% din cazuri. Drept complicaţii s-au identificat procese inflamatorii: abcese, flegmoane -9%; osteomielită posttrau-matică a mandibulei - 7,47%. Concluzii. (1) Datele obţinute relevă o prevalenţă a fracturilor de mandibulă la bărbaţii între 20-40 ani, apţi de muncă.(2) Tratamentul fracturilor de mandibulă are loc mai des prin metoda ortopedică. Complicaţiile de ordin inflamator sunt frecvente, din cauza adresării tardive sau tratamentului incomplet.Introduction. Fracture of the mandible is frequently encountered in dental practice, having a varied clinical course due to the mobility of the mandible, the presence of dental arches and the insertion of the mobilizing muscles. These particularities complicate diagnosis and treatment, and late treatment causes complications. Objective. Clinico-statisti-cal study of patients with mandibular fracture in the IEM during 2024, in order to analyze the frequency of cases, complications and treatments used. Material and methods. Retrospective, analytic study including 107 patients with mandibular fracture hospitalized in the OMF Surgery ward of IEM in 2024.The assessment of the indicators was performed by medical record including the following criteria: age, sex, method of treatment used (orthopedic or surgical). Statistics: Microsoft Office Excel. Results. Based on the study, in 2024 mandibular fractures made up 5.7% of the total number of hospitalized patients. Men were commonly affected- 92.5% being aged between 20-40 years (57% of all cases) and deemed medically fit for work. Women made up 7.47%. Patients hospitalized with recent fractures and treated by orthopedic method (immobilization of the mandible by application of bimaxillary splints) accounted for 61%. The surgical method, osteosynthesis immobilization, was used in 29% of cases. Inflammatory processes were identified as complications: abscesses, phlegmon - 9%; posttraumatic osteomyelitis of the mandible - 7.47%. Conclusion. (1) The study showed a prevalence of mandibular fractures in medically fit men, aged between 20-40 years. (2) Mandibular fractures are most often treated by orthopedic method. Inflammatory complications are common due to delayed or incomplete treatment of this diagnosis