Challenges Regarding the Value of Routine Perioperative Transesophageal Echocardiography in Mitral Valve Surgery.

Background And Objectives: Transesophageal echocardiography (TEE) is considered an indispensable tool for perioperative evaluation in mitral valve (MV) surgery. TEE is routinely performed by anesthesiologists competent in TEE; however, in certain situations, the expertise of a senior cardiologist specializing in TEE is required, which incurs additional costs. The purpose of this study is to determine the indications for specialized perioperative TEE based on its utility and the correlation between intraoperative TEE diagnoses and surgical findings, compared with routine TEE performed by an anesthesiologist.

Utility and Utilization of Patient-Reported Experience Measures for the Supplementary COVID-19 Protective Actions at the Ovidius Clinical Hospital in Romania.

Patient-reported experience measures (PREMs) provide assessments of patients' subjective experiences and perceptions regarding their interactions with the healthcare system and its services. We present a cross-sectional study of the patient perception and evolution of COVID-19 cases performed at Ovidius Clinical Hospital in Romania during the COVID-19 pandemic. The study objective is to explore the utility and the utilization of PREMs in monitoring patient perceptions of the supplementary protective actions.

Alpha-lipoic acid for diabetic peripheral neuropathy.

Background: Diabetic peripheral neuropathy (DPN) is a frequent complication in people living with type 1 or type 2 diabetes. There is currently no effective treatment for DPN. Although alpha-lipoic acid (ALA, also known as thioctic acid) is widely used, there is no consensus about its benefits and harms.

Digital technology for health shows disparities in cancer prevention between digital health technology users and the general population in Romania.

Introduction: Digital health services and technology are rapidly developing following the COVID-19 pandemic. This study aimed to reveal the differences between users of digital health technology (DHT) and the general population with regard to cancer prevention.

Materials And Methods: This was an observational study on a conventional sample of 270 DHT users with completed data, performed in September 2021.

Challenges in Caring for People with Cardiovascular Disease through and beyond the COVID-19 Pandemic: The Advantages of Universal Access to Home Telemonitoring.

(1) Background: Cardiovascular prevention was left in second place during the COVID-19 pandemic and the use of telemedicine turned out to be very useful. We aimed to evaluate the effectiveness of a telemedicine application for remote monitoring and treatment adjustments in terms of improving cardiovascular prevention. (2) Methods: A prospective study of 3439 patients evaluated between the 1st of March 2019 and the 1st of March 2022, in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up.

Telemedicine for Optimizing Secondary Prevention in Coronary Artery Bypass Grafting Patients during COVID-19 Pandemic.

(1) Background: The COVID-19 pandemic has introduced a major disruption to the delivery of secondary prevention measures in patients with established atherosclerotic cardiovascular disease (CVD). It required a rapid and widespread adoption of new medical services, including the use of telemedicine. This study aimed to examine the impact of COVID-19 on secondary prevention in patients with coronary artery bypass grafting (CABG) and to evaluate the effectiveness of the telemedicine application for the implementation of lifestyle change measures, remote monitoring, and treatment regimen adjustment; (2) Methods: This prospective study on 194 CABG patients evaluated three consecutive years between 2019 and 2022 in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up.

Incidence and Risk Factors for Long-Term Persistence of Diastolic Dysfunction after Aortic Valve Replacement for Aortic Stenosis Compared with Aortic Regurgitation.

(1) Background: Severe left ventricular (LV) diastolic dysfunction with a restrictive diastolic pattern (LVDFP) is generally associated with a worse prognosis. Its evolution and reversibility in the short- and medium-term after aortic valve replacement (AVR) has been little-studied. We aimed to evaluate the evolution of LV remodeling and LV systolic and diastolic function after AVR in aortic stenosis (AS) patients compared to aortic regurgitation (AR).

Assessment of the Humoral Immune Response Following COVID-19 Vaccination in Healthcare Workers: A One Year Longitudinal Study.

The continuous variability of SARS-CoV-2 and the rapid waning of specific antibodies threatens the efficacy of COVID-19 vaccines. We aimed to evaluate antibody kinetics one year after SARS-CoV-2 vaccination with an mRNA vaccine in healthcare workers (HCW), with or without a booster. A marked decline in anti-Spike(S)/Receptor Binding Domain (RBD) antibody levels was registered during the first eight months post-vaccination, followed by a transitory increase after the booster.

Practical aspects regarding the histopathological grading and anaplastic transformation of gangliogliomas - a literature review.

Ganglioglioma represents a benign central nervous tumor, occurring predominantly in the pediatric population and affecting the temporal lobe. It is also renowned for its epileptogenic potential. However, to date, there are numerous uncertain features about this tumor, especially about its grading system.

Clinical significance of serum matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 in the first phase of burn trauma evolution.

No prospective study has specifically examined the serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the early shock phase of burn-injured patients. Thus, we aimed to detect early changes, activity dynamics, and the predictive value of MMP-9, TIMP-1, and the MMP-9/TIMP-1 ratio to better understand the early repair mechanisms for the development of future therapies for patients with thermal burns. Twenty-five patients with a total body surface area (TBSA) affected by burn <25%, and 30 healthy subjects were enrolled in the study.

Role and dynamics of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 in burn patients.

Burn injuries can trigger tissue changes that can explain the variation in the level of different biochemical markers that can be recorded both locally or systemically. Some events observed in burn wounds such as vascular hyperpermeability have been associated with the release of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) after trauma. Because it is unknown whether the serum levels of MMP-9 and TIMP-1 are a consequence of these destructions or a local response to thermal damage, we decided to follow their dynamics.

Congenital systemic candidiasis: a comprehensive literature review and meta-analysis of 44 cases.

Systemic candidiasis is a frequent complication in neonatal units, but congenital systemic candidiasis is an unusual diagnosis, observed in both full-term and preterm infants, with less than 50 cases reported to date. Congenital candidiasis presents with a wide spectrum of symptoms, ranging from diffuse skin eruptions to severe systemic disease, resulting in fetal demise or early neonatal death. Although management guidelines have been published almost two decades ago, due to the rarity of this type of infection, conclusive recommendations are difficult to establish, since they are based on anecdotal experience.

Modeling the Puzzle of Hepatitis C Epidemiology in Romania: A Pathway to Control.

Background And Aims: To combat hepatitis C virus (HCV) and achieve its elimination by 2030, the emphasis should be on public health policies. In this study, we investigated the dynamics of epidemiology of HCV in Romanian risk groups that are characterized by higher occurrence densities with the aid of The Let's End HepC (LEHC) project.

Methods: The LEHC project addressed the modelling of HCV epidemiology, being applied in several countries, one of which is Romania.

Modern interdisciplinary monitoring of cervical cancer risk.

Currently, Romania ranks first in Europe with regard to cervical cancer mortality. A new solution proposed for optimizing cytology-based screening, before seeing the risk associated with minor abnormalities results, is the use of molecular markers. This study concerns atypical squamous of undetermined significance (ASC-US) results, the grey zone of cytology that hides up to 15% high-grade lesions, to see how dual immunocytochemistry (ICC) staining for p16INK4a∕Ki67 help to better identify and manage high-risk (HR) ASC-US patients.

Psychometric Properties of the Romanian Version of the Hospital Survey on Patient Safety Culture (HSOPS).

Objective: To explore psychometrics of the Romanian version of the Hospital Survey on Patient Safety Culture (HSOPS) released by the US Agency for Healthcare Research and Quality in 2004.

Material And Methods: The original US survey with 12 composites and 42 items was translated (back translation method), pre-tested on a few staff and then minimally adjusted. A qualitative cross-sectional study was carried out in units from six hospitals in four Romanian regions, based on the census of medical and non-medical staff (n.

Drug Policy in Romania.

Objectives: The objectives of this article were to describe the characteristics of the drug policy in Romania in the last 10 years and to present the consequences in terms of patient accessibility to drugs.

Methods: The Romanian health care system with pricing and reimbursement legislation was studied while considering the evolution of pricing and reimbursement processes, the key stakeholders, and the reasons behind changes. A critical appraisal was done covering published materials on the effects of pricing and reimbursement decisions.

Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children below five years of age in Romania.

Introduction: Rotavirus (RV) is a leading cause of acute gastroenteritis (AGE), affecting 95% of children below five years of age.

Methods: In this prospective, multi-center study, children below five years of age who were hospitalized or those who visited the emergency room (ER) due to AGE or who developed AGE at least 48 hours after hospitalization (nosocomial infection) and had a RV-positive stool sample were included (n=1,222). RV-positive samples were genotyped by reverse-transcriptase polymerase chain reaction.

Recent trends of cancer mortality in Romanian adults: mortality is still increasing, although young adults do better than the middle-aged and elderly population.

We analysed the mortality trends (1986-2009) for all cancers combined and selected cancers in adult Romanians by three age groups (15-49, 50-69 and older than 70 years of age) in comparison with 11 other European countries. We extracted mortality data from the WHO database and grouped the countries into four regions: central and eastern Europe (Romania, Bulgaria, the Czech Republic, Hungary), Baltic countries (Estonia, Latvia and Lithuania), western and northern Europe (Austria, the Netherlands and Finland), and southern Europe (Croatia and Slovenia). Mortality rates were age-standardized against the standard European population.

Analysis of traffic accidents in Romania, 2009.

Unlabelled: This paper aimed to underline the main consequences of traffic accidents in Romania 2009 and their associated causes or circumstances. We identified some problematic geographic areas, some critical months or moments of the day and also the most frequent causes; all these should become targets for the future planning. The current analysis provides some priority criteria for public health interventions.