INCIDENCE AND TIME TREND OF HIP FRACTURES IN ROMANIA: A NATIONWIDE STUDY FROM 2008 TO 2018.

BACKGROUND: Hip fractures are a major issue of public health as they are responsible for high morbidity, excess mortality and costs. There are differences in Europe and worldwide in the incidence rates of hip fractures and time trends, in the context of the population aging. Ten years ago, we characterized the incidence of hip fracture in Romania using data from the national hospital discharge register. OBJECTIVE: This is the first Romanian study to assess the hip fracture incidence rates over a period of 11 years, between 2008 and 2018. SUBJECTS AND METHODS: This analysis is a nationwide retrospective study on hospitals reporting primary DRG data on hip fracture, using a rigorous definition with both diagnostic and surgical procedure codes. The population aged 40+ was stratified in 5-year intervals and both the crude incidence rates and the adjusted incidence rates of hip fracture using standardization on age for the 2018 reference population were calculated in women and men. RESULTS: From 2008 to 2018, the number of hip fractures rose by 53 % in women (from 7513 to 11512) and 22.4 % in men (from 4266 to 5220). Meanwhile, the Romanian population over 40 years increased by 12.5% in women and 14.2% in men. The crude incidence rate rose by 36.2% in women and 7.2% in men and the age-standardized incidence rates by 27.4% in women and 6% in men. These increases are mostly based on 85+ age populations' changes. CONCLUSIONS: In Romania, the hip fractures incidence continues to grow throughout an 11-year-period, especially in women, representing an increasing burden for our society.

Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature.

BACKGROUND: High levels of hospital readmission (rehospitalisation rates) is widely used as indicator of a poor quality of care. This is sometimes also referred to as recidivism or heavy utilization. Previous studies have examined a number of factors likely to influence readmission, although a systematic review of research on post-discharge factors and readmissions has not been conducted so far. The main objective of this review was to identify frequently reported post-discharge factors and their effects on readmission rates. METHODS: Studies on the association between post-discharge variables and readmission after an index discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management, OpenGrey and Google Scholar. Relevant articles published between January 1990 and June 2014 were included. A systematic approach was used to extract and organize in categories the information about post-discharge factors associated with readmission rates. RESULTS: Of the 760 articles identified by the initial search, 80 were selected for this review which included a total number of 59 different predictors of psychiatric readmission. Subsequently these were grouped into four categories: 1) individual vulnerability factors, 2) aftercare related factors, 3) community care and service responsiveness, and 4) contextual factors and social support. Individual factors were addressed in 58 papers and were found to be significant in 37 of these, aftercare factors were significant in 30 out of the 45 papers, community care and social support factors were significant in 21 out of 31 papers addressing these while contextual factors and social support were significant in all seven papers which studied them. CONCLUSIONS: This review represents a first attempt at providing an overview of post-discharge factors previously studied in association with readmission. Hence, by mapping out the current research in the area, it highlights the gaps in research and it provides guidance future studies in the area.

Epidemiologic and Bacteriologic Study of the Burned Patients from the Plastic Surgery Department of the County Emergency Hospital of Ploiesti, over a 4 Years Period (2010-2013).

This study analyses the epidemiologic data and the bacteriologic results of a total number of 759 burned patients, which were treated and discharged from the Plastic Surgery Department of the County Emergency Hospital of Ploiesti, between 01 01 2010 and 31 12 2013. The investigated parameter shave been: age and gender distribution, rural or urban population, burn etiology, total burn surface area (TBSA),TBSA, location and depth of lesions, therapeutic management,length of hospital stay, types of bacteria isolated from the infected wounds and their sensitivity to antibiotics, patients' mortality. The statistical analysis revealed the following results: mean age 51.33 ± 18.44 years, male/female ratio 1.35/1, rural/urban ratio 1.34/1, most common etiologies were scalds (44.8%) and flames (37.6%), mean TBSA 7.7 ± 8.4%, main locations were the extremities, splitthickness skin grafting in 15% of the patients, hospital stay 15.57 ± 13.84 days, main bacteria isolated were Pseudomonas aeruginosa (26.3%) and Staphylococcus aureus (22.9%), mortality rate 0.13%. The best methods to decrease the burn morbidity are the burn and infection prevention, for which several measures are discussed.

Biophysical radiosensitization.

Experimental studies on normal and tumor-bearing rats revealed that chronic treatment with hydroquinone (5 mg/kg/day) inhibited catalase activity in liver, spleen, blood, and H 18R tumor. 3H-hydroquinone (1.5 microCi/g body weight) showed tumor specificity, with maximum radioactivity in the tumor at 1 h after administration. The biological half-time of 3H-hydroquinone in the tumor was 2 h, but there seems to exist a longer component, since 24 h after administration, some 30% of the maximum radioactivity could be detected in the tumor. Hydroquinone treatment produces a specific inhibition of catalase in the tumor and a higher degree of oxygenation at this level. These findings support the assumption that the mechanism of action of hydroquinone as an anticancer agent is achieved mainly via peroxide production. The oxygenation of the hypoxic tumoral tissue is done at non-toxic levels of hydroquinone, through a natural and specific biophysical pathway, recommending hydroquinone for combined anticancer treatment (radiotherapy and chemotherapy).

Immunochemical assays for an early diagnosis of endemic nephropathy.

Comparative studies aiming at the detection of certain tubular protein elements by means of Ouchterlony's immunodiffusion, in parallel with lysozyme and guanase assays, were carried out in the unconcentrated urines of 746 subjects, of whom 655 apparently healthy inhabitants (mostly children) from a region with endemic nephropathy (EN) and from Bucharest, as well as 91 adults with EN or various other diseases with renal involvement. The presence of light chains, of lysozymuria exceeding 2 microgram/ml, of beta2 microglobulin and of guanase in the urines of children and adults from the endemic area was significantly more frequent than in the control groups. These immunochemical changes are hence considered as valuable criteria for the detection of EN prior to the uremic stage. They should be looked for, first and foremost, in the young relatives of patients with this disease. In the stage of nitrogen retention the diagnostic value of these tests is reduced, since the same changes can also be found in the urines of patients suffering from other diseases with renal involvement, which show nitrogen retention as well.

Reduced food intake following cerebral intraventricular infusion of glucose in Gallus domesticus.

Unanaesthetized hens and cocks were infused into the cerebral lateral ventricle with 0.2 ml of a 6% glucose solution or equal volumes of isotonic saline following a 20-hr total food deprivation period. A more marked suppression of food intake occurred in the next 1-3 hr after glucose rather than after saline. The results provide new evidence that chickens possess central glucoreceptors involved in the regulation of their feeding behavior.

Effects of cerebral lateral, ventricular infusions of phloridzin on feeding and body weight in Gallus domesticus (L.).

Contrary to earlier findings in rats, cerebral lateral ventricular infusions of 1 X 10(-3) M or 2 X 10(-3) M solutions of phloridzin at a rate of 2.5 micronl/min for 90 min had no significant stimulating effects on food intake and weight gain in hens and cocks. These different responses to intraventricular phloridzin might reflect a difference of sensitivity to the inhibitory action of phloridzin on glucose transport in cerebral cells or certain peculiarities of mechanisms controlling food intake in chickens.

[Research on hepatic and overall collagen metabolism in irradiated rats (author's transl)]. / Recherches concernant le métabolisme du collagène hépatique et global chez les rats irradiés

The authors studied the effect of ionising radiation on hepatic and overall collagen metabolism in rats. Doses of 100 and 250 rads produced a reduction in urinary hydroxyproline while doses of 500 and 700 rads produced an increase. These results may be interpreted in favour of an increase in reticulation in the first case and in the second case, destruction of inter-molecular bonds. The quantity of total and insoluble collagen increases proportionally to the dose 40 days after the radiation. This proportional relationship is not observed during the first few days after radiation. Prolonged radiation with 700 rads produces a marked reduction in all collagen fractions, compared with 4 days after acute radiation. Among the substances studied, "folcisteine" had the best radio-protective effect when administered before radiation with 700 rads.

Hydroelectrolytic changes caused by prolonged clinical recumbency.

Investigations effected in 16 subjects of 20-69 years at bed rest after bone fractures demonstrated, in an interval of 10-27 days after surgery, normal plasma sodium concentration and a decreased urinary elimination, an increased plasma potassium concentration but a decreased urinary output. The osmotic changes were not significant. The plasma vasopressin activity was increased. Three urinary aldosterone determinations showed an increased output. The serum calcium level was within normal limits but its urinary output was initially slightly decreased, contrary to its augmented elimination after simple voluntary bed rest, as results from literature. The hydroxyproline elimination was increased, demonstrating an active collagen metabolism.

The effects of acute and long-term irradiation on collagen in rat liver.

The alterations of hepatic collagen were investigated at various periods of time after acute (28 min.) and long-term (11 h) irradiation with 100 R, 250 R, 500 R, 700 R. The amount of total and insoluble collagen increases proportionally with the dose 40 days after irradiation, no such a relationship being apparent in the first days after irradiation. The long-term irradiation with 700 R results in a strong decrease of the amount of each of the collagen fractions, as compared with acute irradiation, tested 4 days after irradiation. The most evident protective effect against irradiation was shown by folcystein, as compared with the other agents administered prior to irradiation with 700 R.

Attempts to improve the early enzymatic diagnosis of coronary heart disease.

Based on the hypothesis that beta lipoproteins have the ability to trap certain enzymes, an attempt was made to release these enzymes from the eventual beta lipoprotein blockade, by subjecting the serum to different processings such as: freezing-thawing (3 times), ultrasonation or treatment with Triton X100 or sodium desoxycholate. After the first two procedures an increase of serum LDH and alkaline phosphatase activities was observed in about half the sera investigated (normal and pathologic). In few cases of coronary heart disease (two out of 60), LDH activity reached a clearly pathologic level.

Platelet energetic enzymes.

The LDH isoenzymic pattern was studied in platelet cytolysates from man and rabbits, and the two forms of ATP-ase-the Mg++ and the Ca++ activated ones--were assayed in human platelet cytolysates. In man, the platelet LDH zymogram was of the intermediary type. Some of the zymograms presented 4 fractions others 5; in all patterns the H/M subunits ratio was above 1. In rabbits, the platelet LDH zymogram was of the anodal type with only 4 bands; the H/M subunits ratio showed the same variations as in man. Of the two forms of ATP-ase, the Mg++ activated one was dominant in the platelet cytolysates studied.

The effect of ionizing irradiation on the collagen general metabolism in normal and adrenalectomized rats.

The effect of doses of 100, 250, 500, and 700 R on the urinary excretion of hydroxyproline in normal and adrenalectomized rats was followed over a period of 30 days. Urinary hydroxyproline is decreased by 100 and 250 R doses and increased by those of a 500 and 700 R. The first effect is explained by an increase of the insolubility of collagen as a result of the appearance of additional intermolecular crosslinkages, and the second one by breakage of the mentioned linkages. Adrenalectomized rats, both normal and irradiated, show a more significant decrease in the urinary excretion of hydroxyproline. Results are discussed on the basis of related bibliography, outlining the practical utility of the research.

Plasma corticosterone secretion in rats after irradiation.

In this material it was confirmed that the irradiated rats present a two-phase corticosterone hypersecretion. The responses are greater to higher doses of irradiation (700 R as compared with 500 R). The postirradiation hyperglycemia is not correlated with the corticosterone hypersecretion, having its peak value a day before.

Researches regarding the effect of total x-ray irradiation on the collagen metabolism in rats.

1. Hydroxyproline is an amino acid specific of collagen, so that any changes in its urinary concentration is a proof of the metabolical changes of collagen. 2. The basic value of hydroxyproline in rats investigated by us was of 270 +/- 49 mug/24 hours. 3. The total irradiation with 700 r induced a marked increase of urinary hydroxyproline, beginning after 24 hours and with a maximum level after 48 hours.