Institutional Repository in Medical Sciences of Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Not a member yet
29298 research outputs found
Sort by
ASPECTS OF CLINICAL AND GENETIC DIAGNOSIS IN PFEIFFER SYNDROME
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Sindromul Pfeiffer reprezintă o afecţiune genetică rară cu transmitere autozomal-dominant, cauzată de mutaţii heterozigote ale genei FGFR1 de pe cromozomul 8p11.22-p12 sau genei FGFR2 de pe cromozomul 10q25-q26 cu risc de recurenţă în familie până la 50%. Frecvenţa bolii este de 1 la 100 000 de nou-născuţi. Scop. Prezentarea particularităţilor clinice şi genetice la o fetiţă de 2 luni, pentru a sublinia importanţa diagnosticului precoce în identificarea şi abordarea sindromului Pfeiffer. Material şi metode. A fost evaluat cazul unei fetiţe de 2 luni, cu semne clinice ale unei craniosinostoze asociată cu deformări ale feţei şi ale extremităţilor. Investigaţiile au inclus: examen clinic, inclusiv evaluare ortopedică tomografia cerebrală (CT) cra-niofacială şi teste genetic-moleculare (analiza mutaţiilor în genele FGFR1 şi FGFR2). Rezultate. S-a evidenţiat turice-falie, hipertelorism ocular, hipoplazie a părţii medii a feţei, sindactilie parţială la mâini şi picioare. La CT craniofacial s-a depistat fuziunea prematură a suturilor coronale bilaterale. Analiza molecular-genetică: mutaţie patogenă heterozigotă în gena FGFR2 de pe cromozomul 10q25-q26, care codifică receptorii 2 ai factorului de creştere a fibroblastelor cu rol în căile de semnalizare celulară fundamentală în perioada embriogenezei. Diagnostic: sindrom Pfeiffer tip I. Pacienta a fost inclusă într-un plan de monitorizare multidisciplinară (chirurgie craniofacială, genetică medicală, ortopedie pediatrică). Concluzii. Abordările clinico-genetice aplicate în cadrul consultului medico-genetic, de comun cu metodele de diagnostic neonatal au un rol crucial în identificarea precoce a sindromului Pfeiffer şi la prevenirea complicaţiilor prin tratamentul adecvat încă din primele luni de viaţă.Introduction. Pfeiffer syndrome is a rare genetic disorder with autosomal dominant inheritance, caused by heterozygous mutations in the FGFR1 gene on chromosome 8p11.22-p12 or the FGFR2 gene on chromosome 10q25-q26. The familial recurrence risk can be as high as 50%. The frequency of the disease is 1 in 100,000 newborns. Objective. Presentation of the clinical and genetic features in a 2-month-old girl, highlighting the importance of early diagnosis in the identification and management of Pfeiffer syndrome. Material and methods. A case was evaluated involving a 2-month-old girl presenting with clinical signs of craniosynostosis associated with facial and limb deformities. The investigations included a clinical examination (including orthopedic assessment), craniofacial computed tomography (CT), and genetic-molecular testing (mutation analysis of the FGFR1 and FGFR2 genes). Results. Turiceph-aly, ocular hypertelorism, midfacial hypoplasia, and partial syndactyly of the hands and feet were identified during clinical examination. Craniofacial CT revealed premature fusion of the bilateral coronal sutures. Molecular genetic testing identified a heterozygous pathogenic mutation in the FGFR2 gene on chromosome 10q25-q26, which encodes fibroblast growth factor receptor 2, involved in essential cellular signaling pathways during embryogenesis. Diagnosis: Pfeiffer syndrome type I. The patient was enrolled in a multidisciplinary monitoring plan, including craniofacial surgery, medical genetics, and pediatric orthopedics. Conclusion. Clinical-genetic approaches applied during medical-genetic consultations, in conjunction with neonatal diagnostic methods, play a crucial role in the early detection of Pfeiffer syndrome and in preventing complications by initiating appropriate treatment within the first months of life
The involvement of the clinical pharmacist in monitoring adverse drug reactions in diabetic patients in Moldova
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Monitorizarea reacţiilor adverse la medicamente (RAM) este esenţială în tratamentul pacienţilor cu diabet zaharat, din cauza frecvenţei polipragmaziei şi a comorbidităţilor. Farmacistul clinician are un rol important în identificarea, raportarea şi prevenirea RAM, sporind siguranţa terapiei. Scop. Evaluarea rolului farmacistului clinician în identificarea, raportarea şi gestionarea reacţiilor adverse medicamentoase la pacienţii cu diabet zaharat din Republica Moldova. Material şi metode. A fost realizat un studiu observaţional, transversal, desfăşurat în două instituţii spitaliceşti din Republica Moldova (2023-2024), care a inclus 96 de pacienţi cu diabet zaharat de tip 2. Pentru înregistrarea RAM s-a utilizat o fişă standardizată. Analiza datelor s-a realizat cu SPSS v.25.0, folosind testul x2 (p<0,05). Rezultate. Reacţii adverse au fost identificate la 38,5% dintre pacienţii cu diabet zaharat. Cele mai frecvente reacţii adverse la medicamente reacţii adverse la medicamente au fost gastrointestinale (14,6%), hipoglicemii (12,5%) şi reacţii cutanate (7,3%). Metformina şi gliclazida au fost medicamentele cel mai des implicate. Intervenţiile farmacistului clinician au condus la ajustarea tratamentului în 21,8% din cazuri, ceea ce a dus la reducerea semnificativă a incidenţei RAM la reevaluare (p=0,041), evidenţiind importanţa rolului farmacistului în monitorizarea şi gestionarea reacţiilor adverse pentru a îmbunătăţi siguranţa tratamentului. Concluzii. Implicarea farmacistului clinician în monitorizarea reacţiilor adverse la medicamente (RAM) la pacienţii cu diabet zaharat a avut un impact pozitiv asupra siguranţei terapiei. Rezultatele confirmă ipoteza şi subliniază necesitatea integrării farmacistului în echipa multidisci-plinară.Introduction. Monitoring adverse drug reactions (ADRs) is essential in treating patients with diabetes mellitus due to frequent polypharmacy and comorbidities. The clinical pharmacist plays a key role in identifying and reporting ADRs, contributing to increased safety and effectiveness of pharmacotherapy. Objective. Assessment of the clinical pharmacist's role in identifying, reporting, and managing adverse drug reactions in patients with diabetes mellitus in the Republic of Moldova. Material and methods. An observational, cross-sectional study was conducted in two hospital institutions in the Republic of Moldova (2023-2024), including 96 patients with type 2 diabetes. A standardized form was used to record ADRs. Data analysis was performed using SPSS v.25.0, applying the x2 test to assess significant associations (p<0.05). Results. Adverse reactions were identified in 38.5% of patients with diabetes mellitus. The most frequent adverse drug reactions were gastrointestinal issues (14.6%), hypoglycemia (12.5%), and skin reactions (7.3%). Metformin and gliclazide were the drugs most often implicated. Clinical pharmacist interventions resulted in treatment adjustments in 21.8% of cases, which led to a significant reduction in the incidence of ADRs upon reevaluation (p=0.041). This highlights the crucial role of the clinical pharmacist in monitoring and managing adverse reactions, thereby improving the overall safety of the treatment provided to patients. Conclusion. he involvement of the clinical pharmacist in monitoring adverse drug reactions in patients with diabetes had a significant positive impact on therapy safety. These results confirm the hypothesis and emphasize the need to fully integrate the pharmacist into the multidisciplinary team
Circadian rhythm disruption and anxiety manifestation in medical students after the COVID-19 pandemic
Get PDFIntroducere. Ritmul circadian, este regulat de către nucleul suprachiasmatic hipotalamic (SCN), care integrează răspunsurile neuroendocrine, regimul somn-veghe, funcţiile cognitive, etc. În perioada pandemiei ritmul circadian a fost dereglat, în rândul studenţilor manifestându-se prin tulburări anxioase şi de somn. Scop. Cercetarea relaţiei dintre dereglarea ritmului circadian şi apariţia tulburărilor anxioase în rândul studenţilor medicinişti în contextul pandemiei COVID-19 cu accent pe mecanismele fiziopatologice. Material şi metode. Analiza a 20 de articole ştiinţifice publicate în perioada 2020-2024, identificate în baze de date internaţionale precum PubMed, NCBI, ScienceDirect. Studiile cercetate au urmărit influenţa stresului pandemic asupra ritmului circadian, calităţii somnului, performanţei academice şi echilibrului emoţional la studenţii medicinişti. Rezultate. În urma pandemiei, conform testului Pittsburgh Sleep Quality Index (PSQI) a crescut latenţa de adormire, somnul a devenit mai fragmentat, a scăzut eficienţa somnului şi au apărut tulburări de ritm circadian. La dezvoltarea anxietăţii, fatigabilităţii şi tulburărilor de somn contribuie şi dereglarea axei hipotalamo-hipofizo-adrenale, ca urmare a hipercortizolemiei. Un alt mecanism fiziopatogenetic a fost producţia crescută de citokine pro-inflamatorii (IL-6) atribuită la creşterea excitabilităţii neuropsihice şi stresului psiho-emoţional. Aceşti factori au fost amplificaţi în rândul studenţilor de obligaţiile academice şi izolarea socială. Concluzii. La studenţii medicinişti, în contextul pandemic, perturbarea ritmului circadian şi a somnului cu dezvoltarea tulburărilor anxioase ulterioare, este susţinută de mecanisme precum hipercortizolemie, creşterea markerilor inflamatori, reflectând cauzele fiziologice ale dezechilibrului psiho-emoţional.Introduction. The circadian rhythm is regulated by the suprachiasmatic nucleus of the hypothalamus (SCN), which integrates neuroendocrine responses, the sleep-wake cycle, cognitive functions, etc. During the pandemic, the circadian rhythm was disrupted, manifesting among students through anxiety and sleep disorders. Objective. Exploring the link between circadian rhythm disruption and anxiety disorders in medical students during the COVID-19 pandemic, focusing on pathophysiological mechanisms. Material and methods. This analysis covers 20 scientific articles published between 2020 and 2024, identified through international databases such as PubMed, NCBI, ScienceDirect. The studies researched followed the influence of pandemic stress on circadian rhythm, sleep quality, academic performance, and emotional balance in medical students. Results. Following the pandemic, according to the Pittsburgh Sleep Quality Index (PSQI) test, sleep latency increased, sleep became more fragmented, sleep efficiency decreased and circadian rhythm disorders emerged. The development of anxiety, fatigue and sleep disturbances was also influenced by dysregulation of the hypothalamic-pituitary-adrenal axis due to hypercortizolism. Another pathophysiologic mechanism was the increased production of pro-inflammatory cytokines (IL-6) attributed to increased neuropsychic excitability and psycho-emotional stress. These factors were amplified among students by academic obligations and social isolation. Conclusion. In medical students, in the pandemic context, the disruption of circadian rhythm and sleep with the development of subsequent anxiety disorders is supported by mechanisms such as hypercortisolism, increased inflammatory markers, reflecting the physiological causes of psycho-emotional imbalance
THE IMPACT OF MENTAL HEALTH REFORM ON STIGMA AND POPULATION WELLBEING IN MOLDOVA
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Începând cu 2014, Republica Moldova implementează o reformă a sănătăţii mintale orientată spre servicii comunitare. Aceasta are ca obiectiv reducerea stigmei şi îmbunătăţirea accesului la îngrijiri. Studiul analizează impactul reformei asupra percepţiei sociale şi a bunăstării populaţiei. Scop. Scopul lucrării este evaluarea impactului reformei sănătăţii mintale din Republica Moldova asupra nivelului de stigmatizare asociat tulburărilor psihice şi asupra bunăstării populaţiei. Material şi metode. Lucrarea se bazează pe analiza documentelor furnizate de organizaţia Mensana, care reflectă implementarea reformei sănătăţii mintale în Moldova între 2014-2023. Au fost analizate rapoarte, studii de caz şi materiale de politici, cu accent pe stigma, acces şi bunăstare. Interpretarea s-a realizat prin lectură tematică, în raport cu cadrul OMS. Rezultate. Documentele analizate indică progrese semnificative în reformarea serviciilor de sănătate mintală în Republica Moldova, în special prin extinderea centrelor comunitare şi apropierea îngrijirii de persoana cu tulburări mintale. În regiunile unde reforma a fost implementată activ, s-a constatat o reducere a stigmatizării şi o atitudine mai deschisă faţă de persoanele cu suferinţe psihice. De asemenea, beneficiarii sunt mai implicaţi în propriul proces de recuperare, iar bunăstarea raportată s-a îmbunătăţit vizibil. Totuşi, persistă dificultăţi legate de finanţare, lipsa personalului şi implementarea inegală între regiuni. Concluzii. Reforma sănătăţii mintale din Moldova a adus îmbunătăţiri vizibile în acces, reducerea stigmei şi implicarea beneficiarilor în procesul de recuperare. Cu toate acestea, este necesară consolidarea resurselor, formarea continuă a personalului şi echitatea implementării la nivel naţional.Introduction. Since 2014, the Republic of Moldova has implemented a mental health reform focused on community-based care. The reform aims to reduce stigma, improve inclusion, and expand access to services. This study examines the reform's impact on social perception, service use, and population well-being. Objective. The aim of the study is to evaluate the impact of mental health reform in the Republic of Moldova on the level of stigma associated with mental disorders and on population well-being. Material and methods. This study analyzes documents provided by Mensana, reflecting the implementation of mental health reform in Moldova between 2014 and 2023. Reports, case studies, and policy materials were reviewed, focusing on stigma, access, and well-being. Interpretation was guided by World Health Organization community-based mental health framework. Results. The analyzed documents indicate significant progress in the reform of mental health services in Moldova, particularly through the expansion of community mental health centers and the shift of care closer to individuals with mental health conditions. In regions where the reform has been actively implemented, a decrease in stigmatization and a more open attitude toward people with mental disorders have been observed. Beneficiaries are also more engaged in their own recovery process, and self-reported well-being has visibly improved. However, challenges remain related to funding, insufficient personnel, and uneven implementation across regions. Conclusion. Mental health reform in Moldova has led to visible improvements in access, stigma reduction, and beneficiary involvement in the recovery process. However, sustained progress requires stronger resources, ongoing staff training, and equitable implementation at the national level
Clinical, laboratory and imaging features in spondylarthritis linked to Chlamydia trachomatis: molecular diagnosis and evolution
Get PDFIntroducere. Chlamydia trachomatis este un factor important în declanşarea artritei reactive şi a spondiloartritelor seronegative, cu implicare posibilă şi în artrita reumatoidă. Profilurile clinice, diagnostice şi eficienţa tratamentelor an-tibacteriene în SpA asociată cu această infecţie sunt puţin studiate. Scop. Evaluarea clinică, de laborator şi imagistică a spondiloartritelor asociate cu Chlamydia trachomatis şi investigarea rolului acesteia în boală prin diagnostice moleculare PCR şi NASBA. Material şi metode. Între 2015 şi 2021, 138 pacienţi cu spondiloartrită au fost evaluaţi la Spitalul Clinic Republican „Timofei Moşneaga”. Infecţia cu Chlamydia trachomatis a fost confirmată la 63%. Subgrupele studiate au fost periferică, axială, mixtă şi fără infecţii. Diagnosticul a inclus examene clinice, teste de laborator, PCR, ELISA şi investigaţii imagistice. Rezultate. SpA periferică afectează predominant femeile (76,5%), cu debut în membrele inferioare (81,8%), în special genunchii (63,6%). Po-liartrita apare în stadii avansate (82,3%) şi inflamaţia este uşoară (CRP: 3,3 mg/L, VSH: 13 mm/h). SpA axială predomină la bărbaţi (85,7%), cu afectarea articulaţiilor sac-roiliace (100%) şi genunchilor (61,9%), caracterizată prin inflamaţie intensă (CRP: 37,2 mg/L, VSH: 36,3 mm/h) şi leziuni specifice. SpA mixtă apare după infecţii urogenitale, cu afectare mai redusă a articulaţiilor mici în stadii avansate. ADN-ul Chlamydia trachomatis a fost detectat prin PCR în 89,7% din cazuri, confirmând rolul patogenului. Concluzii. Chlamydia trachomatis este un declanşator confirmat al SpA, detectat prin PCR în probe urogenitale şi sinoviale. SpA periferică are debut poliarticular şi inflamaţie uşoară, iar SpA axială prezintă inflamaţie intensă şi afectare a articulaţiilor mici. Diagnosticul precoce ajută tratamentul.Introduction. Chlamydia trachomatis is an important trigger of reactive arthritis and seronegative spondylarthritis, with possible involvement in rheumatoid arthritis. Clinical features, diagnostic approaches, and the efficacy of antibacterial treatments in Chlamydia-associated SpA remain poorly studied. Objective. Comprehensive clinical, laboratory, and imaging assessment of Chlamydia trachomatis-as-sociated spondylarthritis and its role explored through PCR and NASBA molecular diagnostics. Material and methods. Between 2015 and 2021, 138 patients with spondy-loarthritis were assessed at Timofei Mosneaga Republican Clinical Hospital. Infection with Chlamydia trachomatis was confirmed in 63%. Subgroups included peripheral, axial, mixed, and non-infectious forms. Diagnosis involved clinical evaluation, laboratory tests, PCR, ELISA, and imaging studies. Results. Peripheral SpA predominantly affects women (76.5%), with onset in the lower limbs (81.8%), especially the knees (63.6%). Polyarthritis develops in advanced stages (82.3%) with mild inflammation (CRP: 3.3 mg/L, ESR: 13 mm/h). Axial SpA is more frequent in men (85.7%), with sacroiliac joint involvement (100%) and knee involvement (61.9%), showing intense inflammation (CRP: 37.2 mg/L, ESR: 36.3 mm/h) and specific lesions. Mixed SpA occurs after urogenital infections, with reduced small joint involvement in later stages. Chlamydia trachomatis DNA was detected via PCR in 89.7% of cases, confirming its pathogenic role. Conclusion. Chlamydia trachomatis is a confirmed trigger of spondylarthritis, detected by PCR in urogenital and synovial samples. Peripheral SpA shows polyarticular onset with mild inflammation; axial SpA involves intense inflammation and small joint damage. Early diagnosis improves treatment
Confidentiality – expression of the patient’s right to privacy, the limits of this right and the consequences of its limitation
Get PDFProtecting patients’ personal information is a fundamental principle of
medical practice, necessary for respecting the fundamental right to privacy
and for maintaining a relationship of trust between the patient and the
medical staff. The safe and ethical management of sensitive data not only
ensures individual autonomy, but also encourages patients to openly
communicate relevant information, which is crucial for establishing an
accurate diagnosis. Without confidence that their information is protected,
patients may become reluctant to disclose essential details, which can lead
to medical errors or a decrease in the quality of medical care
Rutkow-Robbins technique in inguinal hernioplasty review
Get PDFIntroducere. Repararea Rutkow-Robbins, cunoscută ca hernioplastie inghinală cu plasă-tampon fără tensiune, este o metodă de referinţă pentru corectarea herniei inghinale. Analiza evaluează etapele operatorii, gestionarea perioperatorie, rezultatele clinice şi pe termen lung şi complicaţiile procedurii. Scop. Scopul lucrării este de a evalua hernioplastia Rutkow-Robbins ca tehnică standard în tratamentul herniei inghinale, prin analiza eficienţei, complicaţiilor şi ratei de recurenţă. Material şi metode. O revizuire sistematică a fost efectuată folosind bazele PubMed, Scopus şi Cochrane Library pentru a identifica studiile relevante publicate între 1993 şi 2023. Analiza s-a axat pe tehnica hernioplastiei Rutkow-Robbins, evaluând demografia pacienţilor, detalii operatorii, rezultate postoperatorii şi date de urmărire pe termen lung. Rezultate. Această revizuire a inclus 27 de studii cu 14.036 de pacienţi, cu vârste între 16 şi 85 de ani, supuşi hernioplastiei Rutkow-Robbins între 1993 şi 2023. Dintre aceştia, 80% au avut hernii primare, iar 20% recidivante. S-a folosit un dop preformat din polipropilenă şi un plasture suprapus. Timpul median al operaţiei a fost de 37 minute (interval: 28-52). Rata recurenţei în 1-7 ani a variat între 0,2% şi 2,5%, media fiind 1,1%. Cele mai frecvente complicaţii au fost: serom (4,0%), he-matom (2,7%), infecţie superficială (1,0%) şi durere cronică (3,2%). Recuperarea a durat 3-18 zile, 70% fiind trataţi ambulatoriu. Spitalizarea a fost de 1,2-3 zile. Concluzii. Hernioplastia Rutkow-Robbins are rate reduse de recurenţă şi complicaţii, fiind considerată o tehnică sigură, eficientă şi reproductibilă. Deşi tratamentul ambulatoriu aduce satisfacţie pacientului, durerea cronică şi prognosticul pe termen lung necesită studii suplimentare.Introduction. Rutkow-Robbins hernioplasty, also known as tension-free mesh-plug repair, represents a foundational technique for inguinal hernia correction. This analysis examines surgical steps, perioperative management, clinical and long-term outcomes, and procedure-specific complications based on current evidence. Objective. The purpose of this paper is to evaluate Rutkow-Robbins hernioplasty as a standard method for inguinal hernia repair by analyzing its effectiveness, complications, and recurrence rate. Material and methods. A systematic review was carried out using the major databases PubMed, Scopus, and the Cochrane Library to identify relevant studies published from 1993 through 2023. The analysis concentrated on the Rutkow-Robbins hernioplasty technique, examining patient demographics, operative details, postoperative outcomes, and long-term follow-up metrics. Results. This review included 27 studies involving 14,036 patients aged 16 to 85 who underwent Rutkow-Robbins hernioplasty between 1993 and 2023. Of these, 80% had primary hernias and 20% had recurrent ones. A pre-formed polypropylene mesh plug and onlay patch were used. The median operation time was 37 minutes (range: 28-52). Recurrence over 1-7 years ranged from 0.2% to 2.5%, with a mean of 1.1%. Seroma was the most frequent complication (4.0%), followed by hematoma (2.7%), superficial infection (1.0%), and chronic pain (3.2%). Recovery ranged from 3 to 18 days; 70% were treated as day cases. Hospitalization lasted 1.2 to 3 days. Conclusion. Rutkow-Robbins hernioplasty demonstrates low recurrence and complication rates, establishing it as a reproducible and dependable method. Although outpatient care improves patient satisfaction, chronic pain and long-term results still demand further clinical evaluations
Masked hypertension: emerging concepts and approaches
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Hipertensiunea mascată (HM) este o formă de hipertensiune în care TA este normală în cabinet, dar crescută în afara acestuia. Fiind frecvent nediagnosticată, HM creşte riscul de complicaţii cardiovasculare şi afectare de organ. Factori implicaţi: stres, inflamaţie, disfuncţie autonomă, vârstă tânără. Scop. Studiul vizează determinarea frecvenţei, severităţii şi mecanismelor HM, precum şi evaluarea metodelor inovative de diagnostic şi opţiunilor de tratament, cu scop de ameliorare a rezultatelor clinice. Material şi metode. A fost efectuată o analiză a literaturii din ultimii 10 ani cu utilizarea PubMed, ResearchGate şi Scopus, axată pe prevalenţa, metode de diagnostic (monitorizarea ambulatorie şi la domiciliu), managmentul şi tratamentul ajustat valorilor tensionale. Analiza s-a realizat conform ghidului PRISMA pentru a asigura rigorile metodologice. Rezultate. Hipertensiunea mascată afectează 10-30% dintre adulţi, mai ales pacienţii cu boli asociate ca diabet zaharat tip 2, obezitate şi sindrom metabolic. Monitorizarea ambulatorie a tensiunii arteriale este cea mai eficientă metodă de diagnostic, deşi, încă se consideră pe larg subestimată. Printre cele mai elocvente cauze patofiziolgice sunt incriminate: activitatea simpatică exagerată, dizautonomia şi inflamaţia vasculară cronică. Rezultatele studiilor demonstrează că intervenţiile comportamentale şi tratamentul medicamentos pot reduce valorile tensionale cu până la 20%, astfel reducând riscul cardiovascular asociat. Concluzii. HM este un risc cardiovascular important, deseori fiind nediagnosticată. Se recomandă monitorizarea tensiunii arteriale în afara cabinetului medical. Studii ulterioare sunt recomandate pentru a dezvolta instrumente standardizate şi tehnologii purtabile pentru a optimiza managementul precoce.Introduction. Masked hypertension (MH) is a silent condition where blood pressure (BP) appears normal in clinical settings but is elevated elsewhere, posing diagnostic challenges and the increasing cardiovascular risk. Autonomic dysfunction, stress, and also inflammation are the key contributing factors. Objective. This research focuses on identifying the prevalence and mechanisms of masked hypertension and assessing new diagnostic technologies and treatment options to enhance clinical outcomes. Material and methods. We conducted a systematic literature review using PubMed, ResearchGate, and Scopus databases. The search focused on studies examining MH prevalence, diagnostic techniques (particularly ambulatory and home BP monitoring), and management approaches. Data were analyzed following PRISMA guidelines to ensure methodological rigor. Results. Our findings indicate that Masked Hypertension is present in 10-30% of adults, particularly in individuals with coexisting conditions such as diabetes, obesity, and metabolic syndrome. Ambulatory blood pressure monitoring (ABPM) remains the most effective tool for MH diagnosis, though its adoption is still limited. The main pathophysiological drivers include heightened sympathetic activity, autonomic imbalance, and vascular inflammation. Evidence supports those behavioral interventions and pharmacologic treatment can reduce blood pressure by up to 20%, thereby lowering the associated cardiovascular risks significantly. Conclusion. Masked hypertension is a major but often missed cardiovascular risk. Prioritizing out-of-office Blood Pressure monitoring is essential. Future studies should develop standardized diagnostic tools and explore wearable technologies to improve early detection and management
Consequences of eyeball contusion. The fine line between light and shadow
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Contuzia globului ocular este un traumatism contondent cu deformarea bruscă a ochiului, caracterizată prin transmiterea unei forţe brute asupra ochiului fără pătrunderea unui obiect în structurile oculare, rezultând leziuni structurale la nivelul segmentelor anterior şi posterior de diferită severitate. Scop. Prezentarea unui caz clinic de contuzie oculară severă cu afectarea polilor anterior şi posterior, complicată cu ruptură capsulară anterioară, cataractă traumatică şi retinopatia Berlin. Material şi metode. Datele anamnestice, clinice şi paraclinice au fost prelevate din fişa medicală a pacientului. Bolnavul a fost investigat prin biomicroscopie, tomografie în coerenţă optică a maculei, ultrasonografie a globului ocular. S-a efectuat intervenţia microchirurgicală de facoemulsificare a cataractei şi iridoplastie la ochiul drept. Rezultate. Bărbat, 50 ani, spitalizat în secţia oftalmologie cu cataracta traumatică, sechele ale traumatismului contodent la ochiul drept. Biomicroscopie: iridodializă, pupila deformată, ruptura capsulei anterioare a cristalinului, opacifieri omogene cris-taliniene. USG - tunicile aplanate, corpul vitros transparent. Tratament: facoemulsificarea cataractei + implantarea pseudofacului + iridoplastie. Postoperator - mediile optice transparente, PF centrat, AV=0.02. OCT macula: alterare focală a stratului fotoreceptor, pierderea structurii benzii elipsoidale şi mioide, alterări la nivelul epiteliul pigmentar - complicaţia secundară a comoţiei retiniene. Concluzii. În pofida faptului că intervenţia chirurgicală a fost efectuată cu succes, postoperator acuitatea vizuală a rămas sub valorile funcţionale satisfăcătoare din cauză leziunii retiniene - Retinopatia Berlin, fiind una dintre cele mai frecvente leziuni retiniene după o contuzie oculară.Introduction. Eyeball contusion is a form of blunt trauma with sudden deformation of the eye, characterized by the transmission of a blunt force to the eye without penetration of an object into the ocular structures, resulting in structural lesions in the anterior and posterior segments of varying severity. Objective. To present a clinical case of severe ocular contusion with anterior and posterior pole damage, complicated with anterior capsular rupture, traumatic cataract and Berlin retinopathy. Material and methods. The anamnestic, clinical and paraclinical data were taken from the patient's medical record. The patient was investigated by biomicroscopy, optical coherence tomography of the macula, ultrasonography of the eyeball. The microsurgical intervention of phacoemulsification of cataract and irido-plasty of the right eye was performed. Results. Male, 50 years old, hospitalized at RCH Department of Ophthalmology with traumatic cataract, sequelae of blunt trauma to the right eye. Biomicroscopy: iridodialysis, deformed pupil, rupture of anterior lens capsule, homogeneous opacified lens. Echo BScan - all the structures are attached, transparent vitreous. Treatment: cataract phacoemulsification + IOL implantation + iridoplasty. Postoperative - transparent optical media, IOL centered, AV=0.02. OCT macula: focal alteration of photoreceptor layer, loss of ellipsoid and myoid band structure, alterations in pigment epithelium layersecondary complication of commotio retinae. Conclusion. Despite the successful surgery, postoperatively the visual acuity of the patient's right eye remained below satisfactory functional values due to retinal injury- Berlin retinopathy, which is considered one of the most common retinal injuries after severe ocular contusion
Importance of the long-eared owl (Asio otus) for rodent control in southern Moldova
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. The long-eared owl (Asio otus L.) is a sedentary and common nocturnal prey
bird. During the winter period, the density of the species increases due to the migrant
individuals from the northern regions and they form colonies of several dozen individuals.
It is well adapted to anthropic environment and its wintering colonies are frequently
registered in localities. After the digestion, owls regurgitate indigestible prey remains as
pellets. After digestion, owls. Studying these pellets provides important data on local small
mammal fauna.
Purpose of the study. This study aimed to determine the diet of the long-eared owl in
southern Moldova and to assess the importance of Asio otus in regulating rodent species
numbers.
Material and methods. A wintering colony of approximately 15 individuals was recorded
in Slobozia Mare, located in a patch of coniferous trees near the village museum.
Approximately 200 pellets were collected during the cold period of 2022–2023. The pellets
were measured and weighed. The bones were then cleaned and categorized. Mammal species
were identified based on skull bones and teeth.
Results. The trophic spectrum of Asio otus was studied during the winter period in Slobozia
Mare, where 212 pellets were collected and 578 individuals were identified. Pellet length
ranged from 16.2 mm to 54.3 mm, with a mean of 32.7 mm. The diet consisted primarily of
small mammals (>90%), with passerine birds making up the remainder. Microtus sp. was
the dominant prey, constituting 58% of the diet and appearing in 72% of the pellets. The
second most abundant and frequent species were from the Mus sp., followed by Apodemus
sylvaticus. Other rodent species had low abundance and frequency. Birds, represented by
Passeriformes, constituted 6.5% of the diet with a low frequency. The total biomass of
consumed prey was 8.12 kg, demonstrating the significance of this predator in regulating
rodent populations during the winter.
Conclusions. After analyzing 212 pellets, 578 individuals were identified. The number of
individuals per pellet varied between 1 and 4, the average being 2.66 individuals. In winter
period the trophic spectrum of long-eared owl consisted of 7 mammal species and birds. The
filed vole dominated in the pellets, constituting about 60%, with a frequency of more than
70%. The second most abundant and frequent species were Mus sp., followed by Apodemus
sylvaticus. Other rodent species had a low share and frequency. The high abundance and
biomass of field voles prove the importance of Asio otus in pest control in open type
ecosystems, including agricultural lands