Therapeutic Options in Pregnant Women with Thrombophilia Depending on the Genetic Mutations- a Prospective Study.

The aim is to evaluate the effects of anticoagulant therapy (Enoxaparine) compared to antiaggregant therapy (Aspirin) on pregnancy outcome depending on the mutational status of clotting factors. The study was conducted prospectively over a 2 years period and included 110 pregnant women, of whom 80 patients diagnosed with hereditary thrombophilia and 30 healthy pregnant women, representing the control group. After careful observation, we concluded a positive influence of Enoxaparine on pregnancy outcome in pregnant women homozygous carriers for factor V Leiden gene mutation and compound heterozygous for Factor V Leiden and Prothrombin G20210A gene mutation. The study did not find significant positive results in women with heterozygous Factor V Leiden and G20210A prothrombin gene mutation who received anticoagulant therapy as well as pregnant women who received low-dose Aspirin compared with controls.

Measuring Patient Safety Culture in Romania Using the Hospital Survey on Patient Safety Culture (HSOPSC).

Purpose To explore patient safety culture among Romanian staff, using the U.S. Hospital Survey on Patient Safety Culture (HSOPSC). MATERIAL AND METHODS: A cross-sectional study was carried out in six hospitals, located in four Romanian regions (Craiova, Cluj-Napoca, Bucharest and Brasov), based on staff census in the Units/hospitals which volunteered to participate in the study (N=1,184). The response rate was 84%. The original questionnaire designed by the American Agency for Healthcare Research and Quality was translated into Romanian (with back translation), pre-tested before application and psychometrically checked. It consists of 42 questions grouped in 12categories, covering multiple aspects of patient safety culture (dimensions). Percentages of positive responses (PPRs) by question and category were analyzed overall and by staff profession. RESULTS: Most respondents were nurses (69%). The main work areas were surgery (24%) and medicine (22%). The highest PPRs were for Supervisor/Manager Expectations & Actions Promoting Safety (88%), Teamwork Within Units (86%), Handoffs and Transitions (84%), Organizational Learning-Continuous Improvement (81%), Overall Perceptions of Safety (80%), Feedback & Communication About Error (75%). The lowest PPRs were for: Staffing (39%), Frequency of Events Reported (59%) and Non-punitive Response to Errors (61%). Nurses exhibited significantly higher PPRs than doctors. CONCLUSIONS: This small-scale study of staff's attitude towards patient safety in Romanian hospitals suggests that there is room for future improvement, especially within the doctor category. Further research should assess the relationship between patient safety culture and frequency of adverse events.

Blood Loss Management in Primary Hip Surgery: Is Reinfusion drain A Feasible Option in Maintaining Hemoglobin Levels?

The management of blood loss in primary hip arthroplasty is a controversial topic. Aim: To evaluate the efficacy of reinfusion drains in terms of hemoglobin levels and volume of red blood cell transfused postoperatively. Material and Methods: 295 patients who underwent primary hip arthroplasty were retrospectively assessed. After applying the exclusion criteria, 94 patients were included in the study and were divided into two groups: 45 patients received a reinfusion drain and 49 a suction drain. The following were analyzed: demographic characteristics of patients, preoperative hemoglobin level, 12-h and 24-h postoperative hemoglobin levels and their variations, number of transfused units of packed red blood cells, and postoperative complications. Results: Kruskal Wallis analysis revealed the homogeneity of the study groups (Chi-square=2.40, df=2, p=0.301). A statistically significant lower decline in mean Hb24 was found in suction drain group (p=0.001). Kruskal Wallis test revealed a significantly more frequent postoperative use of a higher number of packed red blood cell units in the suction drain group (Chi-square=28.70, df=2, p=0.001) compared to reinfusion drain group. Conclusions: We failed to demonstrate the superiority of reinfusion drains versus suction drains in maintaining hemoglobin levels.

Hand abnormalities of the patients with diabetes mellitus.

Hand abnormalities, represented by Dupuytren's contracture, limited joint mobility, carpal tunnel syndrome, flexor tenosynovitis,occur in approximately 50% of the diabetic patients, affecting their activity and decreasing the quality of their life. Using specific methods, these can by detected long before they are observed by the patients. These disturbances have a high prevalence inthe persons with long diabetes mellitus duration, the prevalence increasing with the age. Smoking, usual hard activities, bad metabolic control and so on, can increase the severity of these disturbances. It is compulsory a careful examination of the patients' hands, because more abnormalities can be surgically rightened.