Stress induced by pre-slaughter farm conditions in pigs / [Estresse induzido pelas condições da fazenda pré-abate em suínos]

Cortisol is a steroid hormone, one of the glucocorticoids, made in the cortex of the adrenal glands and then released into the blood, which transports it in the entire body. Almost every cell contains receptors for cortisol and so cortisol can have lots of different actions depending on which sort of cells it is acting upon. These effects include controlling the body's blood sugar levels and thus regulating metabolism, acting as an anti-inflammatory product, controlling salt and water balance and influencing blood pressure. The study was conducted over a period of 3 months, between March-August 2020, in 2 swine farms in Iasi county, Romania, on a total of 46 pigs, 3 to 4 months old, both males and females, in order to investigate stress levels in finishing facilities. The study revealed higher levels of cortisol while eosinophil counts severely decreased, changes which are associated with a strong reaction to stress for individuals that were housed in finishing facilities.(AU)

O cortisol é um hormônio esteroide, um dos glicocorticoides, produzido no córtex das glândulas suprarrenais e, em seguida, liberado no sangue, que o transporta por todo o corpo. Quase todas as células contêm receptores para o cortisol e, portanto, ele pode ter muitas ações diferentes, dependendo do tipo de célula sobre a qual atua. Esses efeitos incluem controlar os níveis de açúcar no sangue do corpo e, assim, regular o metabolismo, atuando como um produto anti-inflamatório, controlando o equilíbrio de sal e água e influenciando a pressão arterial. O presente estudo foi realizado durante um período de três meses, entre março-agosto de 2020, em duas granjas de suínos no condado de Iasi, Romênia, em um número total de 46 porcos, de três a quatro meses de idade, machos e fêmeas, a fim de investigar níveis de estresse nas instalações de acabamento. O estudo revelou níveis mais elevados de cortisol, enquanto a contagem de eosinófilos diminuiu severamente, mudanças que são consideradas associadas a uma forte reação ao estresse para indivíduos que foram alojados em instalações de acabamento.(AU)

Pestivirus spillover effect: molecular detection of bovine viral diarrhea virus in domestic and feral pigs / Efeito spillover de pestivírus: detecção molecular do vírus da diarreia viral bovina em suínos domésticos e javalis

Pestivirus infections are important in the livestock industries, with infection occurring in cattle, sheep and pigs. The Pestivirus genus of the family Flaviviridae, includes four recognized species: bovine viral diarrhea virus 1 (BVDV-1), bovine viral diarrhea virus 2 (BVDV-2), border disease virus (BDV), and classical swine fever virus (CSFV). All pestivirus species can infect pigs, therefore accurate and specific pestivirus detection and differentiation is of great importance to assure control measures in swine populations. The aim of the study was the molecular detection of different pestiviruses in domestic and feral pigs. A total of 527 samples (92 pigs and 435 wild boars) were tested for pestiviruses detection using molecular assays. Eleven positive samples (6 wild boars and 5 domestic pigs) were identified using panpestivirus primers targeting the 5'- UTR region of the pestivirus RNA genome. Further all the positive samples were sequentially tested for detection of CSFV, BVDV-1 and BVDV-2 using specific primers. All RNAs were identified as positives for BVDV-1 and no amplification signals were obtained from BVDV-2 and CSFV. The current detection of BVDV-1 in clinical swine specimens highlights the important risk factor of swine population as reservoir and consequently carrier for BVDV.(AU)

As infecções por pestivírus são importantes nas indústrias pecuárias, com infecções em bovinos, ovinos e suínos. O gênero Pestivirus da família Flaviviridae inclui quatro espécies reconhecidas: vírus da diarreia viral bovina 1 (BVDV-1), vírus da diarreia viral bovina 2 (BVDV-2), vírus da doença de fronteira (VDF) e vírus da peste suína clássica (VPSC). Todas as espécies de pestivírus podem infectar porcos, portanto a detecção e diferenciação precisas e específicas de pestivírus são de grande importância para garantir medidas de controle nas populações suínas. O objetivo do estudo foi a detecção molecular de diferentes pestivírus em suínos domésticos e javali. Um total de 527 amostras (92 porcos e 435 javalis) foram testados para detecção de pestivírus usando ensaios moleculares. Onze amostras positivas (6 javalis e 5 porcos domésticos) foram identificadas usando iniciadores de panpestivírus visando a região 5'-UTR do genoma do RNA do pestivírus. Além disso, todas as amostras positivas foram testadas sequencialmente para detecção de VPSC, BVDV-1 e BVDV-2 usando iniciadores específicos. Todos os RNAs foram identificados como positivos para BVDV-1 e nenhum sinal de amplificação foi obtido do BVDV-2 e CSFV. A detecção atual do BVDV-1 em amostras clínicas de suínos destaca o importante fator de risco da população suína como reservatório e consequentemente portador do BVDV.(AU)

Is rectus abdominis thickness associated with survival among patients with liver cirrhosis? A prospective cohort study

ABSTRACT BACKGROUND: Sarcopenia may affect patients with liver cirrhosis and worsen disease outcomes. OBJECTIVES: To evaluate ultrasound-measured psoas major (PM) and rectus abdominis (RA) thickness for predicting survival among patients with liver cirrhosis. DESIGN AND SETTING: Prospective cohort study in a tertiary-level hospital. METHODS: 61 patients with liver cirrhosis were prospectively included during a 15-month period and followed up for at least six months. Cirrhosis was classified using the Child-Pugh score. Sarcopenia was assessed using surrogate parameters: handgrip strength (HGS), mid-arm muscle circumference (MAMC) and SGA (subjective global assessment). We used ultrasound to measure RA and PM thickness at admission. RESULTS: There were 41 men. The patients' mean age was 58.03 ± 10.8 years. 26.22% of them were Child-Pugh A, 45.9% B and 27.86% C. The patients were followed up for 11.9 ± 5.63 months. RA thickness correlated moderately with MAMC (r = 0. 596; P < 0.0001) and HGS (r = 0.515; P < 0.0001) and decreased with increasing SGA class (A, 10.6 ± 2.8 mm; B, 8.3 ± 1.9 mm; C, 6.5 ± 1.9 mm; P < 0.0001). Survival at six months was independently predicted by using the model for end-stage liver disease-serum sodium score (odds ratio, OR 1.305; 95% OR confidence interval 1.083-1.572; P = 0.005). Survival during follow-up was independently predicted by RA thickness (hazard ratio, HR 0.701; 95% HR confidence interval 0.533-0.922; P = 0.011) and ascites (HR 1.876; 95% HR confidence interval 1.078-3.267; P = 0.026). PM thickness did not have any predictive value. CONCLUSIONS: As a surrogate marker of sarcopenia, RA thickness may predict survival among patients with liver cirrhosis.

The Socialist Camp's North Korean Medical Support and Exchange (1945–1958): Between Learning from the Soviet Union and Independent Course / 의사학

This study focused on the socialist camp's North Korean medical support and its effects on North Korean medical field from liberation to 1958. Except for the Soviet assistance from liberation to the Korean War, existing studies mainly have paid attention to the ‘autonomous’ growth of the North Korean medical field. The studies on the medical support of the Eastern European countries during the Korean War have only focused on one-sided support and neglected the interactions with the North Korean medical field. Failing in utilizing the materials produced in North Korea has led to the omission of detailed circumstances of providing support. Since the review of China's support and the North Korea-China medical exchanges has been concentrated in the period after the mid-1950s, the impacts of China's medical support on North Korea during the Korean War period and the post-war recovery period have not been taken into account. In terms of these limitations, this study examined the medical activities by the Socialist camp of the Eastern European countries in North Korea after the Korean War. The medical aid teams from Hungary, Romania, Bulgaria, Czechoslovakia, Poland, and East Germany that came to North Korea in the wake of the Korean War continued to stay in North Korea after the war to build hospitals and train medical personnel. In the hospitals operated by these countries, cooperative medical care with North Korean medical personnel and medical technology education were conducted. Moreover, medical teams from each country in North Korea held seminars and conferences and exchanged knowledge with the North Korean medical field staffs. These activities by the Socialist countries in North Korea provided the North Korean medical personnel with the opportunity to directly experience the medical technology of each country. China's support was crucial to North Korea's ‘rediscovery’ of Korean medicine in the mid-1950s. After the Korean War, North Korea began to apply the Chinese-Western medicine integration policy, which was performed in China at that time, to the North Korean health care field through China's medical support and exchanges. In other words, China's emphasis on Chinese medicine and the integration of the Chinese-Western medicine were presented as one of the directions for medical development of North Korea in the 1950s, and the experiences of China in this process convinced North Korea that Korean medicine policy was appropriate. The decision-makers of the North Korean medical policies, who returned to North Korea after studying abroad in China at that time, actively introduced the experiences from China and constantly sought to learn about them. This study identified that a variety of external stimuli had complex impacts on the North Korean medical field in the gap between ‘Soviet learning’ in the late 1940s and the ‘autonomous’ medical development since the 1960s. The North Korean medical field was formed not by the unilateral or dominant influences of a single nation but by the stimulation from many nations and the various interactions in the process.

The dermatitis by Caparinia tripilis and Microsporum, in african pygmy hedgehog (Atelerix albiventris) in Romania - first report / Dermatite induzida por Caparinia tripilis e Microsporum em ouriço pigmeu africano (Atelerix albiventris ), na Romênia - primeiro registro

Abstract Investigations were conducted on a case of generalized dermatitis in an African pygmy hedgehog (Atelerix albiventris), purchased as a pet. Clinical examination revealed restlessness, agitation, itching and scratching, large alopecic areas, skin congestion and thin whitish scabs. Five skin lesions were scraped and the samples were collected for laboratory tests. Microscopy revealed the presence of the mite Caparinia tripilis (Acari: Psoroptidae). A dermatophyte belonging to Microsporum genus was also isolated by culture on specific media. Selamectin spot-on and enilconazole washes were used for treatment, resulting in skin healing and spines growing. To our knowledge, this is the first reported case of Caparinia tripilis dermatitis in a hedgehog in Romania.

Resumo Foram conduzidas investigações em um caso de dermatite generalizada em um ouriço pigmeu Africano (Atelerix albiventris), comprado como animal de estimação. O exame clínico revelou inquietação, agitação, coceira e arranhadura, grandes áreas alopécicas, congestão da pele e escamas finas e esbranquiçadas. Cinco lesões de pele foram raspadas, e as amostras coletadas para exames laboratoriais. A microscopia revelou a presença do ácaro Caparinia tripilis (Acari: Psoroptidae). Um dermatófito pertencente ao gênero Microsporum também foi isolado por cultura em meio específico. Para o tratamento foram utilizadas aplicação tópica com selamectina e lavagens com enilconazol, resultando na cicatrização da pele e no crescimento dos espinhos. Possivelmente este é o primeiro caso relatado de dermatite por Caparinia tripilis em um ouriço na Romênia.

The influenza season 2016/17 in Bucharest, Romania - surveillance data and clinical characteristics of patients with influenza-like illness admitted to a tertiary infectious diseases hospital

ABSTRACT Background: Influenza continues to drive seasonal morbidity, particularly in settings with low vaccine coverage. Objectives: To describe the influenza cases and viral circulation among hospitalized patients. Methods: A prospective study based on active surveillance of inpatients with influenza-like illness from a tertiary hospital in Bucharest, Romania, in the season 2016/17. Results: A total of 446 patients were tested, with a balanced gender distribution. Overall, 192 (43%) patients tested positive for influenza, with the highest positivity rate in the age groups 3-13 years and >65 years. Peak activity occurred between weeks 1 and 16/2017, with biphasic distribution: A viruses were replaced by B viruses from week 9/2017; B viruses predominated (66.1%). Among the 133 (69.3%) subtyped samples, all influenza A were subtype H3 (n = 57) and all influenza B were B/Victoria (n = 76). Patients who tested positive for influenza presented fewer comorbidities (p = 0.012), except for the elderly, in whom influenza was more common in patients with comorbidities (p = 0.050). Disease evolution was generally favorable under antiviral treatment. The length of hospital stay was slightly longer in patients with influenza-like illness who tested patients negative for influenza (p = 0.031). Conclusions: Distinctive co-circulation of A/H3 and B/Victoria in Bucharest, Romania in the 2016/17 influenza season was found. While the A/H3 subtype was predominant throughout Europe that season, B/Victoria appears to have circulated specifically in Romania and the Eastern European region, predominantly affecting preschoolers and school children.

Assessment of ultrasonographic and endoscopic changes in dogs with gastrointestinale disorders / Avaliação das mudanças ultrassonográficas e endoscópicas em cães com distúrbios gastrointestinais

The study has been conducted over a period of 4 years, on a total number of 133 dogs, all of those expressing gastrointestinal disorders. Ultrasound and endoscopic examinations were performed in all dogs in order to assess any significant correlations between ultrasonographic and endoscopic findings. The results confirm a significant correlation between the presence of diarrhoea and increased thickness of the large bowel wall, with P<0.5. Another extremely significant correlation we observed is the one between increased thickness of large bowel wall and loss of layering at this level, with P<0.5. Upper GI endoscopy revealed that dilated lacteals in the duodenum are significantly associated with the presence of diarrhoea, P<0.5 and, more importantly, there is a very significant correlation between dilated lacteals and the presence of striations (P<0.5), which confirms previous studies (Sutherland-Smith et al., 2007) that say the striated aspect of the intestinal mucosa is due to dilated lacteals.(AU)

O estudo foi conduzido durante um período de quatro anos, em um número total de 133 cães, todos os que expressam distúrbios gastrointestinais. Exames ultrassonográficos e endoscópicos foram realizados em todos os cães, a fim de se avaliarem as correlações significativas entre os achados ultrassonográficos e endoscópicos. Os resultados confirmam uma correlação significativa entre a presença de diarreia e o aumento da espessura da parede do intestino grande, com P<0,5. Outra correlação extremamente significativa observada é a única entre o aumento da espessura da parede do intestino grosso e a perda de camadas a esse nível, com P<0,5. GI superior endoscopia revelou que lacteals dilatados no duodeno estão significativamente associados com a presença de diarreia, P<0,5 e mais importante, não há uma correlação muito significativa entre lacteals dilatados e a presença de estrias (P<0,5), o que confirma estudos anteriores (Sutherland-Smith et al., 2007) que dizem que o aspecto estriado da mucosa intestinal está a ser dada pelos lacteals dilatados.(AU)

The first report of massive infestation with Lipoptena Cervi (Diptera: Hippoboscidae) in Roe Deer (Capreolus Capreolus) in Iasi county, N-E of Romania / O primeiro relatório de infestação maciça com Lipoptena Cervi (Diptera: Hippoboscidae) em Roe Deer (Capreolus capreolus) no condado de Iasi, NE da Romênia

Investigations of four roe deer corpses were carried out from May until October 2014, in the Veterinary Forensic Laboratory and in the Parasitic Diseases Clinic, in the Iasi Faculty of Veterinary Medicine. The roe deer were harvested by shooting during the trophy hunting season. The clinical examination of the shot specimens revealed the presence of a highly consistent number of extremely mobile apterous insects, spread on the face, head, neck, lateral body parts, abdominal regions, inguinal, perianal and, finally, all over the body. The corpses presented weakening, anemia and cutaneous modification conditions. Several dozen insects were prelevated in a glass recipient and preserved in 70º alcoholic solution in order to identify the ectoparasite species. The morphological characteristics included insects in the Diptera order, Hippoboscidae family, Lipoptena cervi species. These are highly hematophagous insects that by severe weakening are affecting the game health and trophy quality. Histological investigations of the skin revealed some inflammatory reactions caused by ectoparasite Lipoptena cervi. Lipoptena cervi was identified for the first time in Iasi County, Romania.(AU)

As investigações de quatro cadáveres de veados foram realizadas desde maio até outubro de 2014, no Laboratório Forense de Veterinária e na Clínica de Doenças Parasitárias, da Faculdade de Medicina Veterinária de Iasi. Os veados foram abatidos por tiro durante a temporada de caça troféu. O exame clínico dos espécimes revelou a presença de um número muito consistente de insetos ápteros extremamente móveis, espalhados pela face, pela cabeça, pelo pescoço, pelas partes do corpo laterais, pelas regiões abdominal, inguinal, perianal e, finalmente, por todo o corpo. Os cadáveres apresentavam condições de enfraquecimento, anemia e alterações cutâneas. Várias dezenas de insetos foram separados em um recipiente de vidro e preservados em solução alcoólica de 70º, a fim de se identificarem as espécies de ectoparasitos. As características morfológicas incluem os insetos da ordem Diptera, família Hippoboscidae, espécie Lipoptena Cervi. Estes são insetos hematófagos que estão enfraquecendo e afetando a qualidade de saúde de animais de caça e troféu. Investigações histológicas da pele revelaram algumas reações inflamatórias causadas pelo ectoparasita cervi Lipoptena. Lipoptena cervi foi identificado pela primeira vez no condado de Iasi, na Romênia.(AU)

Correlation between adipokines and carotid intima media thickness in a group of obese Romanian children: is small for gestational age status an independent factor for cardiovascular risk?

ABSTRACT Objective To investigate the relationship between markers of adiposity and common carotid artery (CIMT) in obese children born small for gestational age (SGA) versus appropriate for gestational age (AGA), to establish cut-off values for CIMT in obese pediatric populations. Subjects and methods A cross-sectional study was carried out over a 1-year period (Jul 2013 – June 2014). We analyzed 122 obese patients aged 4-20 (mean age 14.9 ± 2.28). Twenty-six patients were born SGA. CIMT was measured in all the patients. Using ROC curve, cut-off values were obtained for both groups. Results We demonstrated a correlation between CIMT and adiponectin, leptin and high sensitivity C-reactive protein (hsCRP) (r = -0.25, r = 0.279, r = 0.498) in obese children. CIMT in obese children born SGA were significantly increased as compared with obese children born AGA of similar age, sex and body mass index (BMI) (p = 0.0035). A CIMT cut off value of 0.049 cm has been obtained with a high sensitivity and specificity. Conclusion CIMT is a well-known marker of subclinical atherosclerosis and its measurement is a noninvasive and inexpensive method of detecting subclinical atherosclerosis. Being born SGA increases the atherogenic risk. Obese children with CIMT above 0.049 cm should be screened for metabolic syndrome (MetS).

Benefits of early enteral nutrition in extremely low birth weight infants

<p><b>INTRODUCTION</b>Extremely low birth weight (ELBW) infants (i.e. preterm infants weighing < 1,000 g) often present with morphofunctional multiple organ immaturity. This study aimed to determine whether early enteral feeding improves digestive tolerance, and whether there is a difference in growth between ELBW infants who were fed with formula and those who were fed with breast milk.</p><p><b>METHODS</b>This study was conducted from 2012-2013 and involved 34 ELBW infants from the Preterm Neonatology Clinic of the 'Louis Turcanu' Clinical Children's Hospital Timisoara, Romania. Early enteral nutrition was introduced for all the infants - Group I was fed with formula, while Group II was fed with breast milk. Infants in each group were given their designated type of milk (formula/breast milk), using the same feeding method and the same volume rate advancement. They were monitored for any evidence of digestive intolerance (i.e. clinical signs of infection and necrotising enterocolitis [NEC]). Their growth curves and signs of infection were also monitored.</p><p><b>RESULTS</b>The average weight gained per week was greater among the infants in Group II than in Group I (120.83 g vs 97.27 g). The incidence of infection was 100% in Group I and 66.6% in Group II. Two of the infants in Group I developed NEC.</p><p><b>CONCLUSION</b>Early enteral feeding helped to improve the weight of ELBW infants. Breast milk was more effective than formula at improving the weight of these infants. Feeding with formula increased the incidence of NEC, invasive infection and morbidity among ELBW infants.</p>

Descriptive Psychiatry and the Development of Diagnostic Criteria in the History of Child Psychiatry and Phenomenological Descriptive Psychiatry

Phenomenology has been developed by philosophers like Kant and Husserl since the late 18th century. Jaspers, a German psychiatrist, adopted it into psychopathology studies and accumulated data by closely observing and recording the patients' symptoms and signs. Among descriptions done even before the psychopathology or diagnostic criteria of disorders in the field of child psychiatry was established, we can find exact and valuable descriptions matching the autism spectrum disorder or attention deficit/ hyperactivity disorder. The diagnostic criteria of modern childhood psychiatric disorders were established based on these grounds. Phenomenological/descriptive methods in various psychiatric fields lead to medical study methods for social phenomenon such as oiettolie, hikikomori, and internet game addiction. Since Romanian orphans were adopted to the western world, descriptive studies along with neurobiological studies on the influence of stimulus deprivation on emotional and physical development are being conducted. While phenomenology, which was adopted by Jaspers to verify psychopathology, was developed mainly by observation and description, recent studies are explaining such descriptive phenomena even at the synapse level due to advances in neurobiology. Although phenomenological/descriptive psychiatry, describing precise and detailed experiences of patients, is less applied nowadays among modern study methods, we must remember that such descriptions may lead to biological studies and provide evidence to improve the accuracy of choosing and applying treatment methods.

Genetic diversity and antimicrobial resistance in Streptococcus agalactiae strains recovered from female carriers in the Bucharest area

For the first time, we used multilocus sequence typing (MLST) to understand how Romanian group B streptococcus (GBS) strains fit into the global GBS population structure. Colonising isolates recovered from adult human females were tested for antibiotic resistance, were molecularly serotyped based on the capsular polysaccharide synthesis (cps) gene cluster and further characterised using a set of molecular markers (surface protein genes, pilus-encoded islands and mobile genetic elements inserted in the scpB-lmb intergenic region). Pulsed-field gel electrophoresis was used to complement the MLST clonal distribution pattern of selected strains. Among the 55 strains assigned to six cps types (Ia, Ib, II-V), 18 sequence types (STs) were identified by MLST. Five STs represented new entries to the MLST database. The prevalent STs were ST-1, ST-17, ST-19 and ST-28. Twenty molecular marker profiles were identified. The most common profiles (rib+GBSi1+PI-1, rib+GBSi1+PI-1, PI-2b and alp2/3+PI-1, PI-2a) were associated with the cps III/ST-17 and cps V/ST-1 strains. A cluster of fluoroquinolone-resistant strains was detected among the cps V/ST-19 members; these strains shared alp1 and IS1548 and carried PI-1, PI-2a or both. Our results support the usefulness of implementing an integrated genotyping system at the reference laboratory level to obtain the reliable data required to make comparisons between countries.

Prediction of the mesiodistal size of unerupted canines and premolars for a group of Romanian children: a comparative study

Objectives The aim of the present study was to develop an optimization method of multiple linear regression equation (MLRE), using a genetic algorithm to determine a set of coefficients that minimize the prediction error for the sum of permanent premolars and canine dimensions in a group of young people from a central area of Romania represented by a city called Sibiu. Material and Methods To test the proposed method, we used a multiple linear regression equation derived from the estimation method proposed by Mojers, to which we adjusted regression coefficients using the Breeder genetic algorithm. A total of 92 children were selected with complete permanent teeth with no clinically visible dental caries, proximal restorations or orthodontic treatment. A hard dental stone was made for each of these models, which was then measured with a digital calliper. The Dahlberg analyses of variance had been performed to determine the error of method, then the Correlation t Test was applied, and finally the MLRE equations were obtained using the version 16 for Windows of the SPSS program. Results The correlation coefficient of MLRE was between 51-67% and the significance level was set at α=0.05. Comparing predictions provided by the new and respectively old method, we can conclude that the Breeder genetic algorithm is capable of providing the best values for parameters of multiple linear regression equations, and thus our equations are optimized for the best performance. Conclusion The prediction error rates of the optimized equations using the Breeder genetic algorithm are smaller than those provided by the multiple linear regression equations proposed in the recent study. .

Antioxidant capacity, phenolic acids and caffeine contents of some commercial coffees available on the Romanian market / Capacidad antioxidante, contenido de ácidos fenólicos y cafeína de algunos tipos de café disponibles en el mercado de Rumania

In the present study a simple and highly sensitive RP-HPLC method has been established for simultaneous determination of chlorogenic acid, caffeic acid, vanillic acid and caffeine in coffee samples. The method has been applied to eight different coffees available on the Romanian market which were previously analysed concerning the total polyphenols content and antioxidant capacity. Reduction of the DPPH radical was used to determine the antioxidant capacity of the coffee extracts while the total polyphenols content was determined by spectrophotometry (Folin Ciocalteu's method). The total polyphenols content ranged from 1.98 g GAE/100 g to 4.19 g GAE/100 g while the caffeine content ranged from 1.89 g/100 g to 3.05 g/100 g. A large variability was observed in chlorogenic acid content of the investigated coffee samples which ranged between 0.6 and 2.32 g/100 g.

En este trabajo, un método sensible RPHPLC fue desarrollado para la determinación simultánea del ácido clorogénico, del ácido cafeico, del ácido vanílico y de la cafeína en las pruebas de café. El método fue aplicado para analizar ocho tipos de café disponibles en el mercado de Rumania, que fueron analizados también en cuanto al contenido total de polifenoles y la capacidad antioxidante. La reducción del radical DPPH fue utilizada para determinar la capacidad antioxidante de los extractos de café mientras que el contenido total de polifenoles fue determinado por la espectrofotometría (método Folin Ciocalteu). El contenido total de polifenoles se situó entre 1,98 g GAE/100 g y 4.19 g GAE/100 g mientras que el contenido de cafeína se situó entre 1.89 g/100 g y 3.05 g/100 g. Una gran variabilidad se observó con respecto al contenido de ácido clorogénico en las pruebas de café analizadas, contenido que se situó entre 0.6 y 2.32 g/100 g.

Consentimento informado e competência em pediatria: opiniões de uma amostra de médicos romenos em treinamento / Informed consent and competence in pediatrics: opinions from a sample of Romanian physicians in training

OBJETIVOS: Analisar o ponto de vista de médicos em treinamento a respeito do consentimento informado como autorização autônoma em pediatria e discutir os efeitos limitantes da norma de competência nesse campo. MÉTODOS: Foi realizado um estudo multi-institucional com 158 residentes de medicina com o intuito de analisar o ponto de vista de médicos em treinamento a respeito do consentimento informado como autorização autônoma em pediatria. A participação no estudo foi voluntária, e os participantes eram provenientes de uma área geográfica limitada (Bucareste e arredores). RESULTADOS: A maioria dos respondentes concordou totalmente que um paciente entre 16 e 18 anos deve tomar decisões médicas informadas sobre qualquer tipo de procedimento (inclusive os referentes a escolhas reprodutivas); enquanto que pacientes entre 14 e 16 anos devem ser autorizados a tomar decisões médicas informadas apenas a respeito de procedimentos menores. A maioria concordou que transplantes de medula óssea devem ser permitidos entre irmãos se aprovados por ambos, enquanto que a maioria não concorda com o transplante de órgãos sólidos. A participação de crianças em estudos clínicos deve ser permitida apenas se a criança concordar. CONCLUSÕES: As respostas obtidas em nosso estudo sobre o consentimento informado aproximam-no mais do sentido de autorização autônoma do que do sentido de autorização efetiva. Portanto, a intuição moral dos participantes é mais bioética e menos jurídica, o que, embora maximize os benefícios do paciente, está associado a um aumento no risco de responsabilidade. No entanto, visto que as gerações mais novas tornam-se cada vez mais precoces, é preciso reavaliar os dogmas tradicionais a respeito da competência.

OBJECTIVES: To assess the views of physicians in training regarding the informed consent as autonomous authorization in pediatrics and to discuss the limiting effects of the competence norm in this field. METHODS: We conducted a multi-institutional survey with 158 medical residents in order to assess the views of physicians in training regarding the informed consent as autonomous authorization in pediatrics. The study was conducted with volunteer participants, from a limited geographical area (Bucharest and surrounding areas). RESULTS: Most respondents strongly agreed that a patient aged 16-18 years should make informed medical decisions regarding any type of procedures (including reproductive choices), whilst those aged 14-16 should be allowed to take informed medical decisions regarding minor procedures only. Most participants agreed that transplant procedures involving bone marrow should be allowed between siblings if they approve, whilst most disagreed allowing solid organ transplantation. The involvement of children in clinical studies should only be allowed if the children agree. CONCLUSIONS: The responses obtained in our study regarding the informed consent put it closer to the autonomic authorization sense than the effective authorization sense. Therefore, respondents' moral intuition is more bioethical and less legal, which, even if maximizing the patient's benefit, is associated with an increased liability risk. However, since the newer generations become more and more precocious, a reanalysis of the classical competence dogmas should be conducted.

Two cases of imported malaria in Western Romania, 2010-2011

Malaria is a major problem for European travelers to endemic regions. In Romania during 1980-2007 approximately 20 imported cases were detected annually. The aim of our short communication is to present 2 interesting cases of imported malaria detected in Western Romania. The first patient was a 20-year female who traveled to India and acquired an infection with Plasmodium vivax (P. vivax). The second patient, a 60-year female, contracted an infection with Plasmodium falciparum (P. falciparum) during a trip to Ghana; the evolution of the disease was severe with many complications and the patient finally died. The cases presented revealed the difficulties in establishing a correct diagnosis of malaria in a non-endemic country, consequences of an incomplete taken anamnesis. Travel history should always represent a mandatory part of a well conducted investigation. At the same time, we must underline the importance of a correct and complete prophylaxis prior to every departure to tropical countries.

Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study / La relación entre el espesor mío-intimal y la densidad mineral ósea en las mujeres posmenopáusicas: un estudio transversal

CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

CONTEXTO Y OBJETIVOS: Hay controversias en cuanto a la relación entre la arterioesclerosis y la osteoporosis. El objetivo del estudio fue determinar la relación entre el espesor mío-intimal (EMI) de la arteria carótida común (ACC), la presencia de placas arterioescleróticas calcificadas, y la densidad mineral ósea (DMO) evaluada a través de absorciometría de rayos X de energía dual (DEXA) en mujeres posmenopáusicas. DISEÑO Y ENTORNO: Estudio transversal en la Segunda Clínica de Medicina Interna, Cluj-Napoca, Rumania. MÉTODOS: Hemos estudiado el EMI (ACC izquierda y derecha y EMI promedio) y el T-score (espina lumbar L2-L4, cuello femoral y cadera total) en 100 mujeres posmenopáusicas (edad promedia 64.5 años). Se ha observado también la presencia de las placas arterioescleróticas calcificadas y de la fractura vertebral osteoporótica. RESULTADOS: El EMI en ACC izquierda y derecha, como también el EMI promedio se ha asociado sobre todo con el T-score medido en la espina lumbar L2-L4, cuello femoral y cadera total o el valor más bajo del T-score, en el grupo osteoporótico, en comparación con el grupo normal y el osteopénico (P < 0.05). Se ha registrado una correlación significativamente negativa entre el EMI y el T-score de espina lumbar, el T-score del cuello femoral, y el EMI promedio con el T-score más bajo. El EMI promedio (P < 0.001), la alta presión (P = 0.005), y las fracturas vertebrales osteoporóticas (P = 0.048) demostraron tener una importancia estadística con respecto a la probabilidad de formación de placas arterioescleróticas. CONCLUSIONES: En el caso de las mujeres sometidas a screening rutinario para la osteoporosis, la relación entre ACC, arterioesclerosis y osteoporosis se puede demostrar utilizando sea la DMO cortical o trabecular. Las fracturas vertebrales se pueden considerar como un factor de probabilidad para el desarrollo de las placas arterioescleróticas.