Influence of Education, Cognition, and Physical Disability on Quality of Life of Romanian Patients with Multiple Sclerosis-A Cohort Study.

Background and Objectives: objective measures of disability and neurological impairmentare used to search for disease activity and monitor disease evolution in multiple sclerosis (MS). These are sometimes in disagreement with subjective quality-of-life measures. We aimed to establish the relations between the Multiple Sclerosis Quality of Life instrument (MSQOL-54) and objective measures of neurological impairment. Materials and Methods: 107 patients with MS were evaluated with the Single Digit Modalities Test (SDMT) for cognition, Nine Holes Peg Test (9HPT) for upper limb function, 25 Feet Walk Test (25FWT) for gait, and EDSS for global disability in a cohort study. Age and education level were recorded as sociodemographic factors. Results: the median EDSS was 3.5 (IQR 2.5); average SDMT score was 30.38 ± 13.54; and 9HPT speed was significantly higher for the dominant upper limb (0.3 ± 0.1 pegs/s versus 0.28 ± 0.11 pegs/s) (p = 0.016). The mental health composite score of the MSQOL-54 correlated with the SDMT, education level, and EDSS. Education level correlated with cognition and quality of life. The physical health composite score of the MSQOL-54 correlated with motor-function parameters and with SDMT. The motor-function parameters correlated well among themselves. A linear regression model found an important influence of SDMT and education level on the mental health composite score of the MSQOL-54. Although the linear regression model predicting the physical health composite score from physical disability parameters was statistically sound, none of the determinants had a significant individual influence. Conclusions: the subscores of the MSQOL-54 correlated well with the objective parameters. The strongest correlations were those with the cognitive function. Correlations with physical disability were less powerful, probably reflecting their indirect and more limited influence on quality of life compared to cognition and perception of disability.

Risk of tuberculosis in low birth weight children from East Romania.

INTRODUCTION: In the context of the global tuberculosis (TB) burden, children represent 10% of all cases, with high incidence rates still reported by many regions worldwide. The study aim was to determine whether there is a correlation between TB clinical diagnosis and low birth weight in children at various ages. MATERIAL AND METHODS: The study was conducted between 2010 and 2014, on a group of 1783 pediatric patients and a subgroup of 137 pediatric patients with low birth weight (LBW). Data were collected from patients' records and hospital statistical reports then processed using MS Excel 2010 and SPSS v.22. RESULTS: The subgroup of LBW patients accounted for 7.68% of all recorded cases. Girls were predominant (total M: F = 0.95; LBW group M: F = 0.91, p < 0.05), most from an urban area (total U: R = 1.29; LBW subgroup U: R = 1.36, p < 0.05). 22.59% of LBW subgroup children were infants aged of 0-12 months. The youngest age at TB diagnosis was 1 month and the lowest weight was 700 g. ANOVA regression for LBW and age at TB diagnosis, showed a multiple R value of 0.0256, p = 0.7659 (F = 0.7659, 95% CI). CONCLUSIONS: The correlation between clinical diagnosis of tuberculosis in children at various ages and their low birth weight was positive but was not statistically significant. However, this research hypothesis should be tested in further studies on larger population groups, due to the current public health context of "End TB", promoted worldwide.

Whole genome sequencing snapshot of multi-drug resistant Klebsiella pneumoniae strains from hospitals and receiving wastewater treatment plants in Southern Romania.

We report on the genomic characterization of 47 multi-drug resistant, carbapenem resistant and ESBL-producing K. pneumoniae isolates from the influent (I) and effluent (E) of three wastewater treatment plants (WWTPs) and from Romanian hospital units which are discharging the wastewater in the sampled WWTPs. The K. pneumoniae whole genome sequences were analyzed for antibiotic resistance genes (ARGs), virulence genes and sequence types (STs) in order to compare their distribution in C, I and E samples. Both clinical and environmental samples harbored prevalent and widely distributed ESBL genes, i.e. blaSHV, blaOXA, blaTEM and blaCTX M. The most prevalent carbapenemase genes were blaNDM-1, blaOXA-48 and blaKPC-2. They were found in all types of isolates, while blaOXA-162, a rare blaOXA-48 variant, was found exclusively in water samples. A higher diversity of carbapenemases genes was seen in wastewater isolates. The aminoglycoside modifying enzymes (AME) genes found in all types of samples were aac(6'), ant(2'')Ia, aph(3'), aaD, aac(3) and aph(6). Quinolone resistance gene qnrS1 and the multi-drug resistance oqxA/B pump gene were found in all samples, while qnrD and qnrB were associated to aquatic isolates. The antiseptics resistance gene qacEdelta1 was found in all samples, while qacE was detected exclusively in the clinical ones. Trimethroprim-sulfamethoxazole (dfrA, sul1 and sul2), tetracyclines (tetA and tetD) and fosfomycin (fosA6, known to be located on a transpozon) resistance genes were found in all samples, while for choramphenicol and macrolides some ARGs were detected in all samples (catA1 and catB3 / mphA), while other (catA2, cmIA5 and aac(6')Ib / mphE and msrE) only in wastewater samples. The rifampin resistance genes arr2 and 3 (both carried by class I integrons) were detected only in water samples. The highly prevalent ARGs preferentially associating with aquatic versus clinical samples could ascribe potential markers for the aquatic (blaSHV-145, qacEdelta1, sul1, aadA1, aadA2) and clinical (blaOXA-1, blaSHV-106,blaTEM-150, aac(3)Iia, dfrA14, oqxA10; oqxB17,catB3, tetD) reservoirs of AR. Moreover, some ARGs (oqxA10; blaSHV-145; blaSHV-100, aac(6')Il, aph(3')VI, armA, arr2, cmlA5, blaCMY-4, mphE, msrE, oqxB13, blaOXA-10) showing decreased prevalence in influent versus effluent wastewater samples could be used as markers for the efficiency of the WWTPs in eliminating AR bacteria and ARGs. The highest number of virulence genes (75) was recorded for the I samples, while for E and C samples it was reduced to half. The most prevalent belong to three functional groups: adherence (fim genes), iron acquisition (ent, fep, fyu, irp and ybt genes) and the secretion system (omp genes). However, none of the genes associated with hypervirulent K. pneumoniae have been found. A total of 14 STs were identified. The most prevalent clones were ST101, ST219 in clinical samples and ST258, ST395 in aquatic isolates. These STs were also the most frequently associated with integrons. ST45 and ST485 were exclusively associated with I samples, ST11, ST35, ST364 with E and ST1564 with C samples. The less frequent ST17 and ST307 aquatic isolates harbored blaOXA-162, which was co-expressed in our strains with blaCTX-M-15 and blaOXA-1.

Acute Bacterial Gastroenteritis as a Healthcare-Associated Infection in Pediatrics.

Despite the fact that acute gastroenteritis can be prevented, the disease still affects children, especially under the age of two. The increased levels of pediatric mortality in most developing regions make diarrheal diseases one of the most common causes of death in the children under the age of 5. The purpose of the study was to describe the cases of acute gastroenteritis reported as healthcare-associated infections in a pediatric hospital deserving the north-eastern urban and rural regions of Romania. MATERIAL AND METHODS: A descriptive study was conducted on a group of 615 cases with acute bacterial gastroenteritis as healthcare-associated infections (HAIs), reported in "Sf. Maria" Emergency Hospital for Children, Iași, between 2012 and 2016. RESULTS: Most cases of acute bacterial gastroenteritis were registered in 2015 (154 cases-25.04%), and the lowest in 2012 (12.84%). Male gender prevailed in almost all years of study, with no statistical significance (p≥0.05). Gastroenteritis with Campylobacter was most commonly reported in pediatric wards, especially in infants of 0-1 years old and children aged of 2-6 years. Cases of HAIs with Salmonella spp were also frequent. CONCLUSIONS: A competent management of HAIs especially as acute gastroenteritis in an emergency hospital for children from a region that includes developing rural areas, should be the most important issue for professionals involved in surveillance and control strategies, as well as clinicians, epidemiologist and microbiologist, in order to prevent HAIs burden occurrence and avoid antimicrobial resistance.

Surveillance Seasonal Program. Antibiotic Resistance of Pathogenic Agents Isolated From Children With Acute Gastroenteritis, in a Region of North-East Romania.

The acute gastroenteritis is a population health problem, frequently met everywhere in the world. In Romania, for certain etiologies the reporting is compulsory. Also, these infections are reported in the TESSy system, too (The European Surveillance System). In this context, antibiotics therapy and antibiotics resistance have a particular importance. The study aim was to assess the prevalence of bacterial pathogens involved in the etiology of acute gastroenteritis (AGE) on the Iasi County, Romania and the surrounding areas and the determination of the profile of resistance to the antibiotics for the identified agents. Material and methods: 72 strains of isolated and identified bacterial agents involved in the acute gastroenteritis (AGE) in the case of children (0-14 years), with the exception of the Campylobacter spp., in the municipality of Iasi and its surrounding areas were studied in 2012, during the surveillance period of AGE (May to October). Results: The most frequent has been the Salmonella spp. (63.9%) from which the S. enterica Thyphimurium in 21 cases (29.2%) and S. enteritidis in 7 cases (9.7%), followed by E. coli (20.8%) from which E. coli O:127 in 3 cases (4.2%), Shigella sonnei S (13.9%) and Yersinia enterocolitica (1.4%). In the case of the children from the group of 0-1 year, the Salmonella enterica Thyphimurium has been the pathogenic agent most frequently encountered (6 cases ­ 29.2%), followed by Salmonella Colindale, S. enteritidis, Shigella sonnei S, E. coli O:127 registered with a frequency of 5.6%. The antibiotic resistance rates are high in the case of ampicillin (43.1%), tetracycline (31.9%), amoxicillin ­ clavulanic acid (26.4%), trimethoprim/ sulfametoxazole (22.2%), sulfonamides (11.1%). Conclusions: The antibiotic resistance rates are high in the case of ampicillin, tetracycline, amoxicillin ­ clavulanic acid, trimethoprim/ sulfametoxazole, sulfonamides.

Patterns of Road Traffic Accident in North-East Romania.

Romania is ranked first among mortality road traffic accidents in Europe. The aim of our study was to evaluate some statistical patterns of population group who unfortunately was admitted at an emergency hospital of Iasi, a large city in the North East of the country. Material and Methods: The study was performed on 1623 patients admitted in the Emergency Room ("Sf. Spiridon" Emergency Hospital of Iasi, Romania) suffering from road traffic accidents, during 2009 and 2013. Results: The prevalence of 19-45 age group cases represented more than 50% of all patients, with a high significance (p<0.05), and men were involved more frequently (69.69%) than women (30.31%); most of the patients were injured while driving an automobile; 6 PM was the "rush" hour (6.4%), Monday was the "black" week day (16.02% of total cases), September the "harvest" time (12.7%), and Summer the "hottest" season (48.49%). Conclusions: The "B plan" is imperative to be implemented in Romania, including better roads, better vehicles, better legislation, and better teens' education, in order to avoid road traffic accidents.

RETROSPECTIVE EPIDEMIOLOGIC RESEARCH ON PREVALENCE OF INFECTIONS IN SURGICALLY TREATED ONCOLOGIC PATIENTS.

UNLABELLED: The aim of this work was the retrospective study of the frequency of infections in surgically treated oncologic patients. MATERIAL AND METHODS: Our research included 753 oncologic patients treated at the Second Surgical Clinic of the Regional Institute of Oncology, Iasi, between January 2013 and December 2014, with the selection of cases which had infectious complications. RESULTS: The lot of patients was structured in 7 age groups and the most frequent oncologic patients had ages between 60-79 years. The most frequent malignancies were large bowel, breast, rectal, esophageal cancers, malignant hemopathies, gastric and liver malignant tumors. In our lot of 753 oncologic patients we depicted 113 (15.01%) infections. CONCLUSIONS: Our study proved that the anatomic location of the cancer, the hospitalization duration and the number of the hospitalizations has an important role in appearance of the infectious complications. The gastrointestinal malignant tumors were the most frequent malignancies associated with postoperative infections. The patients with gastrointestinal cancers from urban area, with ages between 50 and 79 years had the highest risk of infectious complications. For main causative organism was proved a high sensitivity for colistin. Clinical, paraclinical and epidemiological exams did not emphasize any decisive factors; we took into account the risks of infection during multiple pre-, intra- and postoperative procedures; all these have been associated with increased receptivity of immunosuppressed oncologic patients.

QUALITY OF LIFE WITH MASTECTOMY FOR BREAST CANCER, IN TERMS OF PATIENTS' RESPONSES OF SF-36 QUESTIONNAIRE.

UNLABELLED: The aim of the study was to describe the quality of life in female patients with mastectomy performed for breast cancer. MATERIAL AND METHODS: The study was carried out in Iasi, between October 2014-January 2015, on a sample of 23 patients with mastectomy, using the SF-36 Questionnaire (Short Form-36) in a single visit, with direct questioning of patients; a secondary instrument was a general anamnestic questionnaire referring on age group, area of residence, type of surgery, associated diseases, family history, psycho-emotional traumas. RESULTS: The overall profile of the studied case was: woman of 40-49 years (47.8%), from urban area (82.6%), with a family history of neoplastic pathology (43.5%), with psycho-emotional traumas (73.9%) and a self-estimated general health as "moderate" (26.1%), with "a lot of energy" only "some of the time" (43.5%), "feeling worn out" (43.5%), and "cutting down the amount of time spent on work or other activities" (69.6%), with "moderate" (34.8%) or even "intense" (21.7%) "bodily pain", "some of the time" feeling "very nervous" (43.5%) and "so down in the dumps that nothing could cheer her up" (39.1%). The strongest correlation was found between the variable "cut down the amount of time spent on work and other activities" as a result of "physical health" (Role-physical items) and "limited in kind of work or other activities" (r = 0.898 1). CONCLUSIONS: Application of SF-36 Questionnaire in female patients with mastectomy for breast cancer highlighted that strenuous and moderate activities were limited than about half of the surveyed cases, somatic pain affecting their work and normal activities and physical and emotional health influenced the social activity of patients for more than half of the lot. It is necessary to extend the study in order to bring relevant data on the quality of life of these patients, in the social, economic and cultural center of Romania.

ETHICAL AND DEMOGRAPHICAL ISSUES IN SCREENING FOR CERVICAL CANCER--AN OUTLINE IN NORTH EASTERN REGION OF ROMANIA.

AIM: This study complements the national screening program for cervical cancer, implemented in Romania. MATERIAL AND METHODS: Inclusion criteria for this program of active detection of cervical cancer are women aged 25 to 64 years and exclusion criteria were other age groups and the diagnosis confirmed of cervical cancer. The testing was free and used the method of colored cervical smear Pap. RESULTS: In 2013, 23.680 women were tested, that means only 10.13% of the total female population eligible for screening. In 2014, the test group was 6337 (one smear required retesting), of which 5852 were negative results and 484 positive results. Squamous cell abnormalities were detected in 433 women (6.84% of total group who attended the screening). Cervical smears with atypical squamous lesions were present at the most women included in the screening, regardless of age group (67.43%). The screening detected 21 lesions HSIL (4.84%), 2 HSIL with suspicion of invasion (0.46%) and 5 lesions of squamous carcinoma (1.15%). CONCLUSIONS: The presence of a small number of people compared to the female population eligible to the test screening may show the need for a better spread of notions about the screening and the afferent national program, for the population in northeastern Romania, considering the ethical issues that this test assumes.

Epidemiological assessments on incidence of acute gastroenteritis in 0-14 aged children, in the Iasi County, Romania, between 2009-2012.

UNLABELLED: The study aim was to assess the epidemiological potential of acute gastroenteritis (AGE) in children between 2009 and 2012. MATERIAL AND METHODS: We studied two groups; first, a lot of 7237 cases (group A) recorded in the Iasi County through passive surveillance system, reported monthly by the network of primary health care, the assisted outpatients, respectively, those reported by hospitals. The second group (group B) was composed of 4191 hospitalized cases reported also in the passive surveillance system m by telephone, weekly, during only June/end of May to October/beginning of November. Structural peculiarities of the two groups are due to different reporting methodology, so that they were analyzed separately. RESULTS: AGE cases come from urban or rural areas in relatively stable proportions and slightly increased in rural areas compared to urban. The distribution by sex of cases from the group B is maintained at the same shape from one year to another, with a slight predominance in males. The best represented age group in every studied was 0-3 (54.3% of all cases), followed by children between 5 and 10 years with 17.5%). Laboratory investigations have enabled the etiologic diagnosis for hospitalized cases, which ranged from 15.3 to 17.5%, with the exception of 2009 when the diagnosis was noted for almost half of the discharged patients (47.5%). CONCLUSIONS: AGE remains a public health problem in the Iasi County and Romania also, by affecting all age groups, but especially children under 3, an insufficient knowledge of the etiology, and economic losses insufficiently evaluated.

Clinical epidemiological study on the incidence of Escherichia coli infections in the cancer patients admitted to Surgery Department II of the Iasi Regional Oncology Institute in 2013.

UNLABELLED: The aim of study was to identify pathogens involved in hospital-acquired or community-acquired infections in patients suffering from various types of cancers. MATERIAL AND METHODS: A clinical epidemiological study included a group of 355 cancer patients admitted and operated at the Surgery Department II of the Iasi Regional Oncology Institute in 2013 was performed using data from hospital statistical service and the surgery and laboratory records, then processed by epidemi ological and statistical methods. RESULTS: In cancer patients the pathogen most commonly involved in infections was E. coli, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis, Enterobacter cloacae and Acinetobacter. Analysis of bacterial resistance to antibiotics of the pathogen most commonly involved revealed that of the 29 E. coli strains 22 were tested for resistance/sensitivity to ampicillin; of these, 19 strains showed resistance, and only 3 were sensitive; 14 E. coli strains of were resistant to cephalosporins and 8 sensitive; all strains tested were sensitive to carbapenems, imipenem or meropenem and polypeptides (colistin); the 10 tested strains showed resistance to monobactams (aztreonam). CONCLUSIONS: E. coli was incriminated in most urinary tract infections, the other pathogens being identified sporadically. Surgical wound infections were caused mostly by E. coli and Staphylococcus aureus, followed by Pseudomonas aeruginosa. In our study we encountered increased resistance of E. coli to penicillins, cephalosporins, monobactams (aztreonam), fluoro-quinolones and tetracyclines.

Using ArcGIS software in the pre-hospital emergency medical system.

AIM: To measure the accessibility to healtcare services in order to reveal their quality and to improve the overall coverage, continuity and other features. MATERIAL AND METHODS: We used the software ESRI Arc GIS 9.3, the Network Analyst function and data provided by Ambulance Service of Iasi (A.S.I.) with emergencies statistics for the first four months of 2012, processed by Microsoft Office Excel 2010. As examples, we chose "St. Maria" Children's Emergency Hospital and "St. Spiridon" Emergency Hospital. RESULTS: ArcGIS Network Analyst finds the best route to get from one location to another or a route that includes multiple locations. Each route is characterized by three stops. The starting point is always the office of Ambulance Service of Iasi (A.S.I.), a second stop at the case address and the third to the hospital unit chosen according to the patient's diagnosis and age. Spatial distribution of emergency cases for the first four months of 2012 in these two examples is one unequable, with higher concentrations in districts located in two areas of the city. CONCLUSIONS: The presented examples highlight the poor coverage of healthcare services for the population of Iasi, Romania, especially the South-West area and its vulnerability in situations of emergency. Implementing such a broad project would lead to more complex analyses that would improve the situation of pre-hospital emergency medical services, with final goal to deserve the population, improve the quality of healthcare and develop the interdisciplinary relationships.

Descriptive study on acute gastroenteritis in 3,883 patients admitted in "sf. Maria" children hospital from Iasi, Romania, between 2008 and 2013.

UNLABELLED: The aim of study was to assess some population characteristics in children of acute gastroenteritis (AGE) admitted in a regional pediatric hospital. MATERIAL AND METHODS: For the present transversal descriptive study we considered a group of subjects hospitalized for AGE in 2008-2013 (2013--only 6 months) in "Sf. Maria" Emergency Hospital for Children Iasi, Romania. Consultations in the Emergency Unit of this hospital did not take into consideration. RESULTS: Number of AGE cases admitted to "St. Maria" Emergency Hospital for Children Iasi between 2008 and 2013 has seen a steady decline. Male subjects are better represented (54.1%); largest age group 1-4 years, with 1,827 cases, immediately followed by group 0-1 year (1789 cases); together, the two-age groups account for 93.1% of admissions for AGE. Distribution of cases by seasons showed balanced values, with higher percentages in summer (29.7%) and spring (25.5%). The number of cases is relatively constant and lower in winter, affecting predominantly younger groups (0-5 years) compared to the summer when cases aged 5 to 14 years were admitted more frequent. Most cases presented at admission vomiting (41.2%) and fever (40.7%); the presence of bacterial flora was identified in 82.2% of stool specimens, and blood in 13.4% of cases. CONCLUSIONS: A higher number of education measures should be implemented in urban and rural areas in order todecrease the contamination with pathogenic agents involved in infectious acute gas- troenteritis in children.

Some observations on the optimization of pre-hospital emergency medical services from the city of Iasi, Romania.

UNLABELLED: In the lasi City, with a population of 825,100 inhabitants, the number of requests for ambulance service has increased steadily for the past 17 years. One of the determining factors could be the development of the primary health care prevention. MATERIAL AND METHODS: We take into study some factors which consider influencing the reorganization of emergency medical systems in the lasi City territory. RESULTS: According to the spatial analyzes, distribution of health units in lasi City is concentrated type, developing in the downtown area, where there is also a high accessibility to health care services. There are some areas with a high population density, have low accessibility to hospital units, due to the presence of spatial network railroad as a spatial barrier, limiting interaction with other areas of the city. CONCLUSIONS: The analysis of optimization concept of Medical Services in a city like lasi is about the challenge to understand the impact of the population health towards the development and organizing the territory, and, interrelated, how we can improve the population health by the best possible organization.

Variables of job satisfaction in medical assistant profession.

AIM: To identify the key favorable issues, showing a high degree of job satisfaction, and also the adverse issues that may affect the work performance among medical assistants. MATERIAL AND METHODS: This research is a type of inquiry-based opinion survey carried out by administering a self-managed, anonymous questionnaire, consisting of five sections with 25 items. The study group included 175 medical assistants from all specialties, working in public hospitals in the city of Iasi, who answered the questionnaires. A number of 167 subjects have responded, the return rate being of 95.4%. The respondents were asked to indicate the amount of agreement or disagreement on a typical five-level Likert scale. RESULTS: The study has identified some positive aspects: positive perception of the medical assistant profession (76.6%); concern about personal growth and career development (86.3%); good rel ationships established with other colleagues (71.2%), and some negative aspects: inappropriate work conditions and equipments (70%); the income compared to the volume of work was perceived by majority as an important source of dissatisfaction (80.8%); willingness to work abroad (53.9%). CONCLUSIONS: The findings of the present research focused on the variables of job satisfaction in the medical assistant profession and should be a real concern for managers, because the job dissatisfaction may affect the employee's productivity.

[Clinical epidemiological study of acute gastro-enteritis outbreak recorded in a children community, in Iasi, May, 2009]. / Studiu clinico-epidemiologic asupra unui focar de gastroenterita acuta înregistrat într-o gradinita cu program prelungit, din municipiul Iasi, în luna mai 2009.

UNLABELLED: Acute diarrheal disease affect all demographic structures and it is considered a major cause of morbidity and mortality for young age groups; underreporting is due to clinical and epidemiological diversity, everywhere, including the developed countries. MATERIAL AND METHODS: The authors present an epidemic outbreak of acute gastroenteritis by rotavirus in a community of 240 children. Processing and interpretation of collected data was done by statistical, mathematical and computerized methods. RESULTS: A number of 17 cases of acute gastroenteritis caused by rotaviruses were detected and confirmed, mostly in children older than 5 years (92%), with a tendency to focus on large group "A", 40%. All cases showed mild forms evolving medium. CONCLUSIONS: The 17 cases of infection with rotaviruses were the second episode of acute gastroenteritis with the same etiology, reported over two months. Extensivity of the epidemic outbreak was moderate, with the predominant age group affected over six years (58%). Developing and implementing preventive measures included daily cleaning and decontamination standards.

[Assessment of visual function under treatment with topical antiglaucoma agents and systemic vasodilators. Clinical study on glaucoma patients]. / Evaluarea functiei vizuale sub tratament cu topice antiglaucomatoase si vasodilatatoare sistemice. Studiu clinic pe loturi de pacienti cu glaucom, asistati in Clinica a II-a Oftalmologie, Spitalul Clinic de Urgente Prof. Dr. N. Oblu Iasi.

UNLABELLED: The authors present some observations regarding the use of topical anti-glaucoma therapy and systemic vasodilators. MATERIAL AND METHODS: The study was carried out on a series of 996 glaucoma patients, of which 54.1% with primary open-angle glaucoma, 5.7% closed-angle glaucoma, and 17.6% with normal intraocular pressure. RESULTS: Intraocular pressure and visual field were assessed after the use of such therapeutic methods as carbonic anhydrase inhibitors (dorzolamide) and prostaglandin (latanoprost) and dorzolamide (cosopt) association. CONCLUSIONS: The favorable progression of glaucoma could be improved by using new etiopathogenic mechanisms and treatment approaches.

[Some risk factors in breast tumour etiology. Observations in Iasi County between 2006 and 2010]. / Cercetari asupra implicarii unor factori de risc în etiologia tumorilor mamare. Observatii în judetul Iasi, în perioada 2006-2010.

THE AIM OF STUDY: To assess some risk factors and their involvement in female breast tumours etiology. MATERIAL AND METHODS: The study was performed on a sample of 67 patients registered with breast tumours, at family phisicians' offices from Iasi, Romania. RESULTS: Some risk factors were defined such as: nuliparity (20.8%) and first pregnancy after age 30 (34.3%); fibrous mastopathy in personal history (73.1% of cases with breast cancer) and breast cancer in siblings of first (8.9%) and second grade (11.9%). Relative to lifestyle, sedentary life was remarked in 59.2% of patients; modification of circadian rhythm in 28.3%, and excesive caffeine consumption in 80.9% of cases. CONCLUSIONS: Further prevention and educational programs on breast tumoural risk factors are needed in Romania, even at female teenage, performed by family physician.

[Comparative clinical-epidemiological assessments of road traffic accidents: emergency room observations in three counties of Moldavia, Romania, during 2005-2010]. / Evaluari clinico-epidemiologice asupra accidentelor rutiere, comparativ, în unitati de primire urgente: observatii în trei judete ale Moldovei, România, în perioada 2005-2010.

AIM: To assess road traffic injuries according to some descriptive parameters. MATERIAL AND METHODS: The study was carried out on a series of 5374 patients admitted to emergency rooms at Iasi (n=3050), Botosani (n=1187), and Vaslui (n=l137), between 2005 and 2010. RESULTS: Most frequently, the patient was a young, male adult, with cranial cerebral trauma, leg fracture, forearm contusion, or polytrauma, presenting to the emergency room most commonly in the month of August, weekends, and interval noon-dawn interval. CONCLUSIONS: The impact of road trauma epidemic would facilitate a better adaptation of the medical staff to case dynamics and increase the efficacy of primary prevention programs.

[Non-invasive markers of esophageal varices in compensated liver cirrhosis]. / Markeri non-invazivi pentru varice esofagiene in ciroza hepatica compensata.

MATERIAL AND METHODS: There were 91 patients in this study, with liver cirrhosis classified as Child A, diagnosed using clinical, biological and ultrasound methods, and a control group. We used a special questionnaire and biostatistical methods in order to assess the presence of esophageal varices (EV), followed by performing upper gastrointestinal endoscopy (UGE). RESULTS: Models made with biostatistical methods differentiated the cases with or without EV. ROC curve showed sensitivity and specificity values of various parameters. We obtained an overall rate of correct classification of 84.62% for the presence of EV and 71.30% scale assessment. CONCLUSIONS: Using non-invasive tests may be useful as therapeutic and prognostic considerations, to reduce the number of upper gastrointestinal endoscopy in the disease surveillance also.