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The COVID-19 pandemic has caused immense disruption worldwide through its devastating impact on public health, employment and livelihoods. Governments, workers and employers around the world took immediate action to address the crisis, preserve jobs and protect incomes, although these measures varied in scale and generosity. Although such measures were crucial in mitigating the crisis, all countries experienced a sharp deterioration in employment and national income, which exacerbated existing inequalities and risked long-term "scarring" effects on workers and enterprises. Following these events was the multilateral political response to intervene to address social fragility and inequality., {"references":["1.\tRaportul online al Organizație Mondiale a Muncii. COVID-19 and the world of work (COVID-19 and the world of work) (ilo.org)","2.\tRaportul EUROSTAR, Labour market in the light of the COVID 19 pandemic - quarterly statistics - Statistics Explained (europa.eu)","3.\tRaport online al Organizației Mondiale a Muncii. ILO Policy breaf. Policy sequences during and after COVID-191 A review of labour market policy patterns, p.5-6, Policy sequences during and after COVID-19 (ilo.org)","4. Raportul online al Organziației4. Mondiale a Muncii. Word Employment and Social Outlook. Trens 2021. wcms_795453.pdf (ilo.org)"]}

Résumé Le concept de bonne gouvernance est actuel et plein de valeur sémantique. Au fil des ans, il s’est considérablement développé en République de Moldova, qui a contribué et continue de contribuer directement à la consolidation de l’État de droit. À travers cet ar-ticle, nous avons exposé l’idée que l’activisme est le meilleur modèle social pour configurer la bonne gouvernance dans un État de droit. En même temps, nous avons évoqué l’idée que les jeunes, y compris les futurs avocats, par leur propre exemple de comportement, peuvent promouvoir les principes de bonne gouvernance au niveau local et peuvent être activement impliqués dans le processus de prise des décisions en collaboration avec les institutions politiques, locales, régionales et les décideurs nationaux., {"references":["1.\tȘaptefrați T. Buna guvernare: caracteristici, dimensiuni și metode de eva-luare. In: Administrarea publică, nr.3(87), 2015, pp.21-27. ISSN 1813-8489. [citat: 15.12.2021]. Disponibil: https://ibn.idsi.md/ro/vizualizare_ articol/39075","2. Weber M. The Theory of Social and Economic Organization. New York: The Free Press, 1947. eISBN 978-1-439-18887-3. . [citat: 15.12.2021]. Dis-ponibil: https://books.google.md/books?hl=ro&lr=&id=G3TYBu6-4G0C &oi=fnd&pg=PT17&dq=The+Theory+Of+Social+And+Economic+Organ ization&ots=XsMeXInzB0&sig=NIGAEVK7M466k4IZKVNXOMo9sKM& redir_esc=y#v=snippet&q=1947&f=false (Google Scholar)","3.\tȘaptefrați T. Buna guvernare: caracteristici, dimensiuni și metode de eva-luare. In: Administrarea publică, nr.3(87), 2015, pp.21-27. ISSN 1813-8489. . [citat: 15.12.2021]. Disponibil: https://ibn.idsi.md/ro/vizualiza-re_articol/39075","4.\tHințea C. Introducere în administrația publică. Suport de curs pentru învățământ la distanță – anul I, Semestrul I, Cluj-Napoca, 2013-2014, 142p. . [citat: 15.12.2021]. Disponibil: https://www.academia.edu/10359074/Introducere_%C3%AEn_administra%C8%9Bia_public%C7%8E_-Su-port_de_curs_pentru_%C3%AEnv%C4%83%C5%A3%C4%83m%C3%A 2nt_la_distan%C5%A3%C4%83_-anul_I_semestrul_I-_UNIVERSITA-TEA_BABE%C5%9E-BOLYAI_CLUJ-NAPOCA","5.\tȘaptefrați T. Buna guvernare: caracteristici, dimensiuni și metode de eva-luare. In: Administrarea publică, nr.3(87), 2015, pp.21-27. ISSN 1813-8489. [citat: 15.12.2021]. Disponibil: https://ibn.idsi.md/ro/vizualizare_ articol/39075","6.\tEuropean governance - A white paper /* COM/2001/0428 fi-nal */. Official Journal 287 , 12/10/2001 P. 0001 – 0029. [citat 15.11.2021]. Disponibil: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex:52001DC0428","7.\tȘaptefrați T. Buna guvernare prin prisma participării cetățenilor la pro-cesul decizional. In: Administrarea publică, nr.1(105), 2020, ISSN 1813-8489, pp.22-29. . [citat: 15.12.2021]. Disponibil: https://ibn.idsi.md/ro/vizualizare_articol/98173","8.\tWorldwide Governance Indicators. [citat: 15.12.2021]. Disponibil: http://info.worldbank.org/governance/wgi/","9.\tTransparency and Open Government. Congress of Local and Regional Au-thorities. Report CG35(2018)14 final, 7 November 2018. [citat: 15.12.2021]. Disponibil: https://rm.coe.int/transparency-and-open-government-go-vernance-committee-rapporteur-andre/16808d341c","10.\tAcord de asociere între Republica Moldova, pe de o parte și Uniunea Euro-peană și Comunitatea Europeană a Energiei Atomice și Statele Membre ale acestora, pe de altă parte. Preambul. In: Jurnalul Oficial al Uniunii Europe-ne, L 260/4, 30.08.2014. [citat: 15.12.2021]. Disponibil: https://eur-lex.eu-ropa.eu/legal-content/RO/TXT/?uri=CELEX%3A22014A0830%2801%29","11.\tHotărârea Guvernului cu privire la aprobarea proiectului de lege pentru aprobarea Strategiei Naționale de Dezvoltare \"Moldova 2030\", nr.377, din10.06.2020, pp.32-33. [citat: 15.12.2021]. Disponibil: https://can-celaria.gov.md/sites/default/files/strategia_nationale_de_dezvoltare_ moldova_2030-t.pdf","12. Strategia Națională de Dezvoltare Moldova 2030. [citat: 15.12.2021]. Dis-ponibil: https://particip.gov.md/ro/strategy_category/o-guvernare-mai-efectiva-responsabila-transparenta-si-incluziva/30","13.\tConvenția cu privire la drepturile copilului. Adoptată de Adunarea Gene-rală a Națiunilor Unite, 20.11.1989. [citat: 15.12.2021]. Disponibil: https://www.unicef.org/moldova/media/1401/file/Conventia-cu-privire-la-drep-turile-copilului.pdf","14.\tUNICEF Moldova. [citat: 15.12.2021]. Disponibil: https://www.unicef. org/moldova/ce-facem/educa%C5%A3ie/implicarea-tinerilor","15. Ghid pentru participarea tinerilor în comunitate. Chișinău, 2019. [citat: 15.12.2021]. Disponibil: http://cntm.md/sites/default/files/Ghid%20par-ticiparea%20tinerilor%20%5Bprint%5D.pdf"]}

Reading gives emotional balance and conceptual freshness. It is a natural way to save normality in a pandemic period. Rather than be victims of these times, schools ought to offer solutions. Taking this into consideration, the Bookland4Teens eTwinning project had an interdisciplinary dimension that allowed the correlation of several artistic languages and proposed a model for adapting school and extracurricular activities to the new conditions, capitalizing on the digital skills of the representatives of generation Z. &nbsp

The present article presents a short analysis of the legal regime of the administrative contentious claims against the Government Ordinances, showing that the control of the courts of justice is limited, by report to the legal nature of the acts under analysis. Also, the article presents the conditions to be fulfilled by the administrative contentious claims against the Government Ordinances, showing that these claims have as object: the award of damages for the tort caused by the Government Ordinances, the annulment of the administrative acts, the obligation of the public authority to issue an administrative act, the obligations of the public authority to perform a certain administrative operation.

The article presents the legal regime in public law applicable to the mandate of the local representatives. Unlike the private law mandate, the public law mandate is not defined in any normative act, does not have a detailed regulation, his juridical nature and characteristics being established by the doctrine, starting from the common fundament of the public and private law mandate, which is of the essence of the mandate. The interdiction of the imperative mandate is in fact a means of protection of the freedom and independence of the members of the Parliament. On the political side, the disregard of the commitments of the elected person towards the political party may have as a consequence the expulsion from the party. In the second part of the article the arguments for a unitary regime of the national and local public law mandate are presented. In addition to that proposals have been made, on one side for reconsidering the case law of the Constitutional Court with respect to the public law mandate and the modification of Law no. 393/2004 concerning the local representatives, and on the other side, in accordance with the constitutional provisions which forbid the interactive mandate.

Granulomatosis with polyangiitis (GPA or Wegener) is a systemic autoimmune disease with inflammation of small- and medium-size vessels. It can affect practically any organ or system, but renal, respiratory andjoint systems are most frequently damaged. Positive pANCA antibodies can raise the suspicion of diagnosis. Subglottic stenosis is relatively frequent, in a quarter of patients, especially in the third decade women. The case presented is of an 80-year-old woman, recently diagnosed with pulmonary, renal and systemic manifestations of GPA and with a subglottic stenosis rapidly evolving towards endotracheal intubation, tracheostomy with mechanical ventilation and renal failure. Further evolution has been favorable under corticoid therapy. After weaning from the mechanical ventilation and30 days after the suppression of the tracheostomy, the patient developed a tracheal stenosis with mixed etiology, secondary to vasculitis and prolonged intubation with tracheostomy. Tracheal resection with termino-terminal anastomosis was performed in emergency with simple post-operative evolution and without late complications.

Acinetobacter baumannii (A. baumannii) is one of the leading causes of morbidity and mortality in patients who are in critical condition in hospitals and especially in intensive care units (ICU). Long time considered a bacterium with low virulence, A. baumannii has more recently become a cause for major concern in clinical practice due to its high level of antimicrobial resistance. The extend of infections with Acinetobacter baumannii in ICU is caused by multiple factors, such as mechanical ventilation, invasive procedures, the use of a large number of broad spectrum antibiotics and transmission through the hands of medical staff In this study we evaluated the resistance to antibiotics of 213 non-duplicated strains of A. baumannii isolated in the bacteriology laboratory of the "Marius Nasta" lnstitute of Pneumophtisiology (IPMN) from January 2012 to December 2013. These strains originated from patients in medical wards (56), ICU (143) and surgery (14). Strains identification was performed by classical methods on multitest media and with API kits (Bio Merieux). The antibiotic sensitivity was performed on Mueller-Hinton media in accordance with CLSI2013. Analysis of the resistance to antibiotics was the following: carbenicilin (87.3%), ceftriaxone (87.3%), cefoperazone with sulbactam (84.9%), ceftazidime (79.3%), carbapenems (imipenem and/or meropenem--75.1%), fluoroquinolones (ciprofloxacin and/orlevofloxacin--73.7%), cefepime (66.6%), piperacilin with tazobactam (62.4%), amikacin (50.2%), netilmicin (45%), gentamicin (42.7%) and tobramycin (35.6%). In our study, we only found two strains of Acinetobacter baumannii with resistance to colistin and 70 (32.8%) strains sensitive only to colistin, but resistant to all other antibiotics tested. A. baumannii is a pathogen with rapid spread and extended resistance to even newer antimicrobial agents. Due to its ability to survive in the hospital environment, A. baumannii has the immense potential to cause nosocomial infections. We did not find significant differences between the antibiotic resistance of strains isolated from ICU patients and those obtained from medical or surgical wards. This study has also shown that there is a high number of A. baumannii strains with resistance to almost all antibiotics tested, notably with the exception of colistin, wich therefore becomes the antibiotic of choice in the treatment of these infections. The marked increase in the number of multidrug resistant A. baumannii strains highlights the need for a more rational use of broad spectrum antibiotics, as well as for an immediate review of infections control protocols, so as to limit the spread of this pathogen.

The authors present the case of a 53-year-old female, initially admitted in a rheumatology department for fever and diffuse arthritis--being diagnosed with sero-positive rheumathoid arthritis. Although the chest X-ray and CT scan of thorax showed several abnormal features (medium lobe atelectasis, pseudo-cyst in the posterior segment of the right upper lobe with satellite milliary nodules, mediastinal lymph node enlargement), the investigations performed in our pneumology department couldn't establish the etiology of radiological abnormalities. With non-steroidal antiinflamatory treatment, the patient got worse, being readmitted in our hospital after 3 months for high fever, diffuse arthralgia with functional impairment, small hemoptysis, loss of hearing and left ear ache and on chest X-ray with bilateral macronodules, some of these with cavitation. The investigations showed a slight alveolar hemorrhagic syndrome, positive cANCA antibodies, negative antiCCP antibodies--the diagnosis of Wegener's granulomatosis with lung and ENT involvement being established. Puls-therapy with Solumedrol and i.v. Cyclophosphamide was thereafter initiated with a favorable evolution. This case is special because of the initial misdiagnosis due to the atypical pulmonary manifestations and the non-specific paraclinical findings, in the context of diffuse arthritis with positive rheumatoid factor.

This study analyzes a series of iatrogenic tracheal stenosis occurring in patients with COPD exacerbation which required oro-tracheal intubation. The tracheal stenosis occurred on average after 24 days of intubation and were clinically severe. Treatment algorithm first included bronchoscopic interventional techniques with an immediate success rate of 37%, but the results were unstable in time, requiring tracheal stenting. The surgical approach, which generally is the first choice in the treatment of tracheal stenosis, had discouraging results in these patients, with a low rate of success (20%) and an increased incidence of restenosis. The only solution for those postoperative complications was, again, interventional bronchoscopy. In conclusion, while for various other etiologies of tracheal stenosis the surgical resection is the first choice of treatment, in COPD patients interventional bronchoscopy often remains the only way of solving.

The paper presents the case of a 52-year-old Caucasian female with several comorbidities (diabetes mellitus II, transitory ischemic stroke, sarcoma of uterus -operated, chemotherapy), which was addressed to the pneumology department for the diagnosis of sarcoidosis, established through mediastinoscopy followed by histopathological examination of lymph node biopsies. Further investigations performed in our department sustained the diagnosis of stage I sarcoidosis and expectative without systemic corticotherapy was the clinicians' decision. The follow-up during several months showed spontaneous remission of the mediastinal adenopathies except one, in the medium lobe, which was supposed to have other ethiology than sarcoidosis. Surgical excision of this tumor and several lymph-node biopsies was performed through right thoracotomy; the histopathological exam sustained the diagnosis of "ganglionar metastasis from endometrial sarcoma' but immunohistochemical tests showed that it was a "sclerosing hemangioma of the lung" - tumor with benign evolution. The coexistence of adenopathies of different and rare etiologies make this case interesting, the different evolution of these adenopathies suggested the different morphological pattern of them.

Sedation in patients with acute or chronic respiratory disease needing ventilatory support is provocative. Agitation, anxiety and pain interfere with the measures to alleviate respiratory failure and to improve gas exchanges (invasive or non-invasive ventilation), while most sedatives and analgetics are respiratory depressants. Benzodiazepines, propofol and opioids are widely used, but it does not exist a consensus in medication selection, sedation and pain score scales recommended, implementation of protocols of sedation and recovery from the drugs administrated. The use of old and new sedative/analgesic medication, frequently combined, generates the need for understanding pharmacological interferences and for a strategy in preventing oversedation. Creating a specific protocol and guidelines in each respiratory ICU for sedation/analgesia in mechanically ventilated patients can improve outcome and reduce the ICU and hospital stay.

Esophageal resection remains a dreadfull surgical intervention accompanied by consistently higher morbidity and mortality when compared with other surgical procedures. The respiratory complications are the most important contributor to morbidity and mortality after this kind of surgery. Intimate knowledge on risk factors and physiopathology and careful treatment of these complications go with good postoperative results. This article discusses the factors affecting respiratory complications and strategies to reduce the incidence of these complications after esophagectomy

Bronchopleural fistulas and empyema are the most devastating complications after lung resection. The optimal management remains a major subject of controversy for thoracic surgeons over the wide variety of therapeutic approaches, none suitable for all patients. In 1996 Azorin et al. reported the first successful mediastinoscopic reclosure by stapling of an insufficient bronchial stump after left pneumonectomy using video-assisted mediastinoscopy. The authors report the first national case of left-sided bronchopleural fistula closure using video-assisted mediastinoscopy, describing their experience with this technique. A 40 years old woman presented to our unit with left thorax empyema after having undergone left pneumonectomy for TB destructed lung with aspergillosis in another hospital. Bronchoscopy revealed a 15 mm long bronchial stump with insufficiency. Despite all advances made over the last decades in perioperative management, bronchopleural fistula after pneumonectomy remains a significant problem in thoracic surgery. Video-mediastinoscopy is an alternative to the open methods as it allows approaching the bronchial stump via the mediastinum. The dissection of the trachea through its natural route enables bronchial mobilization. Positive factors influencing our decision were the virgin mediastinum with no surgical dissection and no radiation therapy applied. The mediastinoscopic approach for bronchial stump closure after pneumonectomy is a novel option in highly selected patients. This is our choice for a long (at least 10 mm) bronchial stump because its morbidity is minimal compared with transpericardial sternotomy or a transthoracic approach. It warrants minimal surgical trauma; however, skilled surgeons with experience in mediastinoscopy have to be prepared to convert to an open technique immediately.

Quality of life in relation to health is a consequence of disease and treatment on the patient's perception of his ability to have a full and useful life. Due to its nature, the quality of life is a multidimensional and subjective construct, based on the patient's experience. We operationalized the quality of life using the following parameters: CD4 count and HIV viral levels in the patient's blood, the number of days of hospitalization, number of antiretroviral plans, types of side effects and their frequency, psychological issues (anxiety, depression, and neurotic tendencies).We centralized data from a total of 600 patients from the Regional Center in Iaşi in 2010-2011. Side effects accused by the patients emerged from discussions with the infectious disease doctor and psychologist, and psychological aspects were measured by specific instruments (PA Inventory, Beck Depression Scale).Most patients enrolled in the study were male (59%) with mean age of 21.1 years. 34% of them came from rural areas. Average schooling level was 6 primary classes, with extremes between the two classes of primary and higher education. Only 14% of patients had a job, while the rest did not have a stable job or were not employed. 38% came from broken homes or foster care. 85% of patients were in therapy at the time of data centralization. 55% were in the second, third or fourth regimen. 25% were at their first scheme, while 10% in the seventh - eighth scheme. The mean CD4 count ranged between 13 and 269/mmc, while the average viral load varied between 1730 and 3.180.000/mmc. The average number of days of hospitalization was 4. Among the antiretroviral side effects patients complained nausea and vomiting in 85% of cases, lipodystrophy symptoms in 25% of cases, diarrhea 15%. With regard to psychological aspects, 65% of patients showed an above average level of anxiety, 40% showed depressive symptoms, while 10% had specific obsessions-compulsions, and 10% neurotic and hysterical tendencies.By measuring the quality of life through the above parameters, we obtained a clear and comprehensive picture of the situation facing the HIV patient. We believe that close cooperation between the team of doctors and psychologists assisting the infectious patient, on the one hand, and specialists in other medical fields that interact with the patient, on the other hand, can enhance the quality of life of the HIV patient and maintain it at a comfortable level.

Based on the biochemical composition of erythrocyte membrane and asymmetric distribution of phospholipids, proteins, and cholesterol, FT-IR spectroscopy can monitor the distribution and interaction pattern of membrane constituents.The study series included 21 clinically healthy subjects aged between 20 and 60 years. Complete blood counts were performed and the serum biochemical compounds (cholesterol, triglycerides, total protein, glucose) were determined.The parameters that can be assessed by erythrocyte FT-IR in relation with the biochemical factors that may influence membrane fluidity are: degree of fatty acids unsaturation, saturated fatty acids/unsaturated fatty acids ratio, cholesterol/phospholipids ratio, and phospholipids/protein ratio. Based on the obtained results, in the assessment of membrane status the following vibration modes were selected as spectral parameters: vibration associated valence bond (=CH), asymmetric valence CH2 groups, modes associated with P=O bond and amine bands I and II specific for proteins. Other parameters, such as v(C-O) specific to glucose, may provide additional information on glucose metabolic status.By correlating biochemical markers with these spectral parameters information on red cell membrane status, status that may reflect different pathological processes, can be obtained.

Neuroendocrine tumors, known as carcinoid tumors constitute a heterogeneous group of neoplasms that present many clinical challenges. They secrete peptides and neuroamines that cause specific clinical syndromes. Assessment of specific or general tumors markers offers high sensitivity in establishing the diagnosis and they also have prognostic significance. Management strategies include curative surgery, whenever possible-that can be rarely achieved, palliative surgery, chemotherapy, radiologic therapy, such as radiofrequency ablation and chemoembolisations and somatostatin analogues therapy in order to control the symptoms. The aim of this paper is to review recent publications in this field and to give recommendations that take into account current advances in order to facilitate improvement in management and outcome.

Blood transfusion is usually meant to lower morbidity and mortality rates. Allogenous blood transfusion implies certain risks that can be avoided by autologous blood transfusions techniques including: preoperatory autologous blood donation, acute normovolemic hemodilution, intraoperatory and postoperatory blood salvage. Preoperatory blood donation and acute normovolemic hemodilution are used for planned interventions with an estimated blood loss higher than 20% of blood volume. These methods imply Erythropoietin and iron treatment. Intraoperatory and postoperatory blood salvage is performed by personnel trained in blood donation, handling and storage. Autologous blood transfusions are used for certain surgical procedures that commonly require transfusions: orthopedic surgery, radical prostatectomy, cardiovascular surgery, organ transplantation. An alternative to allogenous blood transfusion is the use of artificial oxygen transporters: human or animal hemoglobin solutions or pefluorocarbonate solutions. These solutions do not require cross reactions, do not carry diseases and are generally well tolerated and easily stored in the operating room, ambulance and other transport means. They have however a slight degree of toxicity.

Complete thymectomy plays an important role in the myasthenia gravis (MG) pacient's treatment. Many different surgical techniques have been developed to achieve thymectomy. Of these, thoracoscopic technique is the most recent. There still are many controversies about the most suitable approach for thymectomy. The paper presents in detail the video-assisted thoracoscopic extended thymectomy--VATET-technique, and initial results with this procedure. Prospective data was obtain according to the Myasthenia Gravis Foundation of America (MGFA) recommendations. From Mai 2007 to December 2009, 15 patients with MG underwent the VATET procedure with cervical access. There was no conversion to sternotomic approach. Mean operating time for complete VATET was 215 min (150-280 min), with the cervical procedure requiring 44 min (25-60 min). There was no mortality or intraoperative complications. It was a single case with a thoracoscopic second look for hemothorax from intercostals bleeding. At this time, due to the reduced number of cases, we can't evaluate the therapeutic effectiveness of the VATET. We consider VATET as a valuable surgical option to treat myasthenic patients, with an optimal report between radicality and invasiveness.

Between November 2001-April 2010, 107 tracheal resections were performed in our department for different types of tracheal stenosis: iatrogenic or tumoral, benign or malignant. We present the diagnosis and treatment principles that we used, along with our results. We operated on 74 (69.15%) iatrogenic postintubation tracheal stenosis, 6 (5.6%) of them complicated with tracheo-esophageal fistula, 6 (5.6%) benign tumors, 11 (10.28%) primary malignant and 16 (14.97%) secondary malignant ones, with a 3.8% total mortality. Tracheal resection and reconstruction is the only curative treatment for all types of tracheal stenosis. Interventional endoscopy is of a major importance in the assessment and treatment of tracheal stenosis. We believe that each patient diagnosed with a tracheal stenosis should be referred to a tertiary center with multidisciplinary experience in the treatment of tracheal stenosis.

Prokaryotes are the most abundant living organisms and also most diverse from genetically and metabolically point of view, being responsible for the majority of biogeochemical processes playing the most important role in life cycle on the planet. Considering this, there is a general agreement among taxonomists, that there is a very small number of bacterial species recognized and described today, mostly because of controversial issues concerning bacterial species concept. One of the most accepted approaches, even today, is the polyphasic taxonomy because it is based on diverse information, obtained from classic taxonomy but also from molecular level. The development of new molecular techniques, especially sequencing rRNA genes conducted to an improved concept, that we intended to evaluate in this review, and even more, to reconstruction of group specific phylogenetic tree.

The authors present the results of retroprospective clinical and laboratory diagnosis on toxocariasis cases hospitalized in the Paediatric Diseases Clinic of Iaşi, between January 2005-June 2008.The study included a number of 228 children.The most frequent clinical manifestation was pulmonary symptoms 80.70%: dyspneea, wheesing, asthma, cough, interstitial pneumonitis. The most frequent digestive symptoms were abdominal pain 41.22%, hepatosplenomegaly 29.38%; cutaneous manifestations were pruritus and urticaria. The laboratory diagnosis: hypereosinophilia was present at 94.73% childrens associated with hyperleucocytosis and hyper-gammaglobulinemia. All the patients were serologic confirmed with toxocariasis. The children responded well to treatment with albendazole.

The authors presents the results of a retroprospective epidemiological study on toxocariasis cases admitted in the Paediatric Diseases Clinic of Iaşi, between January 2005 - June 2008.The study included a number of 228 children.The age distribution highlighted a predominance of 3-7 years of age group (46.9%); sex distribution, a significant predominance in males (53.5%) and a small advance the rural areas (54.3%) given the urban areas (45.6%). The present study lead to a spring-autumn seasonality. A high risk for infection is the dog (41.2%). The distribution of toxocariasis in children patients in Moldavia, Romania, highlighted a predominance in Iaşi county (45.6%).

The 21st century's demographic and epidemiologic perspectives suggest an absolute and percentual increment of elderly population. In the same time the prevalence of heart insufficiency increases with advanced age, which transforms heart failure in a true challenge for health insurance system. This new dimension of the problem resides in the increment of heart insufficiency's prevalence and in the high costs of medical care of these patients. Heart failure's medical costs are high not only due to the necessity of compensating the cardiac function but also due to the necessity of treating the etiology, the risk factors and the co-morbidities with cardiac side effects. Elderly patients usually have a low therapeutic compliance and an important number of iatrogenic reactions mainly due to poly-medication, poly-pathology and cognitive and physical deficiencies, which need special measures of therapeutic education for the patient and family and medical survey, probably best in a nursing house; all these elements increase significantly the cost, which is almost double than the cost for cancer. The prophylaxis in heart insufficiency means an extremely efficient management of entire cardiac pathology in order to delay the moment of heart failure. In elderly patients, the treatment in heart insufficiency is difficult not due to hospital treatment of decompensation episodes but due to low therapeutic compliance at home. We need special programs to ensure medical education of the patient and the family/caregiver in order to avoid iatrogenic pathology and to ensure therapeutic efficiency.

The negative pressure achieved in the hemi thorax in the case of lung pneumonectomy has consequences on the mediastinum organ statics. This condition results through the other lung expansion. These changes are common, but rare in adult lung pneumonectomy. In the case of right lung pneumonectomy, the mediastinum moves to the operated part and disturbs the function of the vessels and cavities with thin wall or low pressure (vena cava, right atrium). These aspects are not observed in the case of left lung pneumonectomy. Taking this into consideration the authors present the case of a young woman with right lung pneumonectomy, an intervention made in childhood, at ten years old. After sixteen years of evolution a serious mediastinum re-shuffle was discovered, the heart was moved in the right hemi thorax, with a dextrocardia like aspect. This case is interesting because it raises positive and differential diagnosis problems--dextrocardia, associated disorders, serious complications.

Besides their important biotechnological and industrial applications, yeasts have been used during the last years, in obtaining probiotic products, along with lactic acid bacteria and various enzymes. Our study deals with some aspects regarding the use of yeasts as animal and human probiotics, and their possible mechanisms of action. Also, we present information on probiotic products synthesized by international and national companies. Finally, there are described future prospective of research concerning the applications of recombinant yeast strains as basis for obtaining new bio-drugs. In conclusion, the data comprised in this paper, presents an interesting argument for using yeasts as biotherapeutic agents, an alternative to conventional treatments.

This work points out the access ways - both the classical ones and the ones less known and used - to the origin and the first centimeters of the superior mesenteric artery (SMA), underlining the advantages and disadvantages of each of them.Our work is based on dissection of 30 human bodies and 200 selective arteriographies.There are two classical ways to access the first part of SMA: inter-duodeno-pancreatic and the left thoraco-abdominal ways.An access way to the origin of the SMA is necessary for the revascularisation through different techniques of the visceral territory depending on the SMA, taking into account the fact that at this level we have the most frequent localization of the atheroma plaques, which leads to acute or chronic intestinal ischemia (manifest in the form of postprandial abdominal 'angor').

Chronic obstructive pulmonary disease - COPD, being one of the most frequent chronic pathologies in the world, an important number of such patients can necessitate, at a certain moment, a thoracic surgical intervention, especially pulmonary resections for pulmonary carcinoma. In these cases, the removing of a certain volume of pulmonary tissue from a patient who already has a respiratory malfunction necessitates a judicious preoperative evaluation to establish the correct indication, risk factors and postoperative prognosis (at least regarding the pulmonary function). Although the preoperative evaluation for pulmonary resections has been studied for many years, a parameter has not been found yet, simple or combined, to accurately predict the outcome. The majority of the candidates for pulmonary resections can be operated without previous complicated tests like CPET (cardio-pulmonary exercise testing) and regional pulmonary function, which are expensive and sometimes non accessible. In the past years, CPET gained more and more field in the appreciation of the surgical risk; combined with the split measurement of the function of the two lungs, it can even predict the postoperative effort capacity. In the complex preoperative evaluation of the chronic pulmonary patients we must not forget other, not so obvious aspects, so that the patient could benefit by the optimum moment and health status for his or her operation, for the purpose of a better prognosis.

This paper analyses the experience of the Paediatric Surgery Department from the Emergency Hospital in Craiova regarding the clinical and therapeutical evaluation of 55 cases with appendicular plastron admitted in our department between 1997-2006. We analyse both the evolution and the complications in managing these cases, together with particular aspects of differential diagnosis related to this group of age. These 55 cases were children aged between 2 and 15 years with a 15 days average hospitalization period. Applying a standard treatment we had favorable results in 85% of cases with 15% cases underwent surgical treatment from the first admission. Comparative to a study realised in our dept. between 1975-1996, which registered 30 cases with a mortality of 6.70%, the present one revealed in the latest years an important increase of the number of appendicular plastron with a significant low mortality.

Discussions about the impact of iatrogeny over general health were avoided and neglected for a very long time. It was brought to medical interest due to recent studies concerning therapeutic compliance, patient's medical education and acute awareness of ethical implications of medical activities. Even if iatrogeny was always present in medicine, we realized but recently the dimensions and the necessity of a coherent and systematic approach of this problem. Iatrogenic pathology in elderly population has even a bigger impact due to conjugation of two major demographic phenomena: an absolute and percentage increase of elderly population parallel with an increase of prevalence of iatrogenic pathology with age. That's why iatrogeny in elderly becomes a major health problem, unfortunately often ignored, neglected and even obscured inspite of well-recognized impact over duration and quality of patient's life as well as over the cost of medical assistance.

A retrospective study of anesthetic and surgical techniques involved in 55 consecutive cases of tracheal and carinal resections completed from 2001 to 2007, is presented. The anesthetic maneuvers and surgical approach differed in relation with the site of the tracheal lesions (upper, middle, lower trachea or carinal), the degree of the obstruction, the emergency of the surgical intervention and the concomitant presence of the eso-tracheal fistula. Ventilatory support during anesthesia involved special equipment adapted to the particular techniques used in this type of surgery. Cross field intubation of trachea or a mainstem bronchus, and High Frequency Jet Ventilation-HFJV- have been frequently used. Perfect coordination of the anesthetic techniques with every surgical step is mandatory and for good long term results special anesthetic equipment and a good preoperative anesthetic and surgical assessment of the strategy is needed.

The authors present the case of a female patient with a left lower lobe resection 30 years before, performed for bronchiectasis, operated 6 years before for a secretory adenocarcinoma of the uterus, presenting for severe dyspnea and cough with abundant serous sputum secretion (over 500 ml per day). In the right lung there were several great cysts which proved to be metastasis of the uterine adenocarcinoma. The patient had severe loss of lung volumes, respiratory failure and a single left lobe. Nonetheless a right pneumonectomy was performed for palliation, addressing the cough and huge expectoration. After surgery the symptoms improved significantly and the patient survived another 6 months in decent condition.

The article presents the case of a female admitted for the suspicion of pulmonary TB (clinical and radiological pattern compatible with this diagnosis), in which the lack of bacteriological confirmation together with a rapid and dramatic deterioration of clinical, radiological and functional status excluded tuberculosis and oriented the diagnosis towards a severe alveolar hemorrhage; further tests confirmed a Wegener granulomatosis with pulmonary, renal and ORL manifestations. The evolution was rapidly favorable using pulse-therapy with cyclophosphamide and methylprednisolone i.v. The particularities of this case were: the use of helmet device for correction of the extremely severe hypoxemia for 3 weeks (no other studies reported such a long continuous duration of use of this device) and the lag between the pulmonary and the renal impairment.

Down syndrome, determined by 21 trisomy, represents a major cause of infantile morbidity and mortality.The analysis of dysmorphic features in Down syndrome, incidence of major congenital abnormalities, of some epidemiological parameters and cytogenetic specifics.Methods used were clinical, epidemiological and cytogenetical. We analysed 221 patients, from Iaşi county, with clinical supposition of Down syndrome, identified in the first year of life, between 1985 and 1999.The majority of patients (67%) have more than 5 from 10 characteristics dysmorphic signs of Down syndrome in neonatal period. Visceral congenital abnormalities--82 cases (37.1%) were isolate (cardiac or digestive) or multiple. The presence of one visceral abnormality determined the death of patient in 30 cases (46.15% of death). Medium incidence of Down syndrome in Iaşi county was 1.306 per thousand (1/769 new-born), with median value 1.091per thousand and corrected value related to the maternal age 1.056 per thousand. Cytogenetic analysis was performed at 101 patients, in 95 cases (94.05%) clinical suspicion of Down syndrome was correct, patients presenting 21 trisomy (in the majority of cases a homogenous free trisomy).The data obtained by us are concordant with the majority of literature studies, that a test the correctness of clinical trial and validate our results.

Neuropsychiatric systemic lupus erythematosus (NPSLE) has become a popular term designing all neurological and psychiatric complications in patients with systemic lupus erythematosus (SLE). It occurs in up to two thirds of all SLE patients and it covers a vast array of disorders ranging from peripheral neuropathy to stroke, psychosis, and dementia. Mechanisms associated with the pathogenesis of NPSLE include anti-neuronal antibodies, antiphospholipid antibody associated thrombosis, emboli from cardiac source and, rarely, vasculitis by immune complex depositions. Although the most common manifestations is cognitive dysfunction (50%), NPSLE may also present itself as peripheral neuropathy (15%), psychosis (10%), or other central nervous system abnormalities (stroke, organic brain syndrome, seizures). In lupus patients, one should always look for secondary causes of the neuropsychiatric manifestation, including infection, toxic metabolic abnormalities, and hypertension. We present two cases of SLE, which developed neuropsychiatric manifestations.

The technological revolution of the 20th century has changed not only the life style but also the human interrelations, including the physician-patient relationship. The old, primarily patriarchal, system (in which the patient trusted completely the physician and followed religiously his commandments) evolved into the current system in which the patient is an active partner in medical care. Patient education is increasingly recognized as an integral part of the therapy. The objectives of therapeutical education rely essentially in the improvement of the patient knowledge and skills concerning the disease and its treatment in order to harmonize his life style with the restrains of the illness. Therapeutical education must be complex, individualized, repeated, motivating, and controlled. In chronic diseases, both the health provider and the patient are in front of a permanent challenge. The educational process is in continuous movement, liable to permanent improvement.

The aim of the study was to characterize the clinical and histological picture of a malignant cardiac tumor, to assess the prognosis and to develop a management strategy. We described a primary cardiac sarcoma, located in the right ventricle. Minimal invasive right thoracotomy was used and a partial surgical excision of the malignant cardiac tumor was made as a palliative procedure. The malignant cardiac tumour continues to have a poor prognosis despite of the individualization of the approach.

The aim of the paper was the morphological study of the cardiac myxomas, admitted and operated at CCI, between 2000 and 2004. We evaluated the histology of the tumor, the incidence of the specific lesions, and we analysed the tumoral types on the basis of cardiac myxoma macroscopic appearance in correlation with clinical picture of tumor.

Coronary artery disease has a significantly higher prevalence in chronic dialysis patients compared to the general population, explained by a cluster of non-specific and specific (uremia-associated) cardiovascular risk factors, typical for these patients. Nephrologists and cardiovascular surgeons worldwide are rather reluctant to offer CABG to dialysis patients, because of concerns about higher risks associated with this procedure in this frail population. However, there is an increasing opinion supporting a more aggressive management of coronary artery disease in uremic individuals. To illustrate this "positive attitude", we report here the first dialysis patient ever treated by CABG in Iaşi; his good outcome was both rewarding and encouraging for us all.

Due to the major impact of yeasts in human life based on the existence of pathogen yeast species and of species with biotechnological abilities, in the last few years new molecular techniques are performed for an accurate identification of natural isolates. Our study is aimed to review some of these techniques such as electrokariotyping by PFGE (Pulsed Field Gel Electrophoresis), estimation of the molar percentage of guanine and cytosine, the applications of PCR reaction in yeast identification using RAPD (Random amplified polymorphic DNA), UP-PCR (Universally Primed Polymerase Chain Reaction), MLST (Multilocus sequence typing) techniques, mtDNA and rDNA homology studies. Such molecular techniques complete the phenotypical characterization based on classical taxonomical tests allowing thus the polyphasic identification of the microorganisms.

Visceral Leishmaniasis is a multi-organic parasitic disease caused by an intracellular protozoon named Leishmania Donovani; the mean signs are: weight loss, cough, fever, hepatosplenomegaly, adenopathy and cutaneous lesions; death without treatment is the rule. The main treatment is a conservative one. Surgical treatment is necessary for complications, especially for those intra-abdominally. We wish to present a young female patient who underwent two subsequent interventions due to an unclear diagnosis. We emphasize the difficulties in achieving a certain diagnostic, because of the rarity of disease in Romania; there are also revealed surgical aspects, which are important because of very few available data in the literature.

The pseudo- Meigs syndrome is defined as a pelvic tumour, other than the ovarian fibroma complicated with ascites and hydrothorax that can be recovered after the tumour is surgically extirpated. The uterine leiomyoma is an extremely rare cause of this syndrome, only 24 cases have been recorded so far, most of them presenting hydropic degeneration or necrosis. The case exposed by us, a 50- year old obese,with nanism woman, presented clinical, biological and imaging characteristics of the syndrome; moreover, she had arterial high blood pressure for more than five years, fact that didn't need postoperative treatment. She was sent to the ER because she had severe respiratory insufficiency, arterial high blood pressure, tachycardia and, at the clinical examination, she presented massive right hydrothorax, ascites, and pelvic tumour. The biologic explorations (the benign cytology in the pleural liquid and ascites, CA-125 with ten times the normal value) and the imagery completed the picture of a Meigs/ pseudo-Meigs syndrome that implied the laparotomy. The H-P examination and the postoperative evolution confirmed the diagnosis. We presented this case in order to emphasize both its rarity and its real positive and differential diagnosis problems.

Gastroschisis is a severe congenital malformation of the abdominal wall, with relative low incidence. The authors are analysing different therapeutic methods, in a group of 17 cases, hospitalised and operated in Department of Pediatric Surgery, Emergency Hospital of Craiova. They are underlining the importance of the ultrasound prenatal diagnosis of the malformation, close related to different therapeutic methods applied in this period of time and also are advising secondary closure of the abdominal wall, using a synthetic material (Silo-bag) for temporary coverage of the intestine developed outside the peritoneal cavity. This method helped with the decreasing of mortality in gastroschisis but with high costs of treatment.

The aim of this study was to delete two genes from the genome of the fission yeast S. pombe in order to search for their functions in the cell. These genes are SPAC869.02c (MRI) and SPBC21C3.19 (MR2) and previous studies reported their significant induction after gamma irradiation. We carried out the deletions of the two genes and we replaced them with the selection marker ura4. Among the phenotype characteristics we tested the viability, the sexual behaviour and the radiosensitivity to ultraviolet and gamma irradiation. Our results indicate that MR1-deleted strain is sensitive to both UV and gamma irradiation, while the survival of the irradiated MR2-deleted strain doesn't appear to be influenced by the deletion. This suggests an involvement of MR1 gene in the adaptive response triggered by these types of genotoxic aggression. The comparison of MR1-d and MR2-d with the double deleted strains containing the deletion of MR1 or MR2 combined with the deletion of sty1 or rad3 genes led to a surprising result: the double mutants MR1-d sty1-d and MR1-d rad3-d were more resistant to both UV and gamma irradiation than the simple deleted strains sty1-d and rad3-d, respectively. This suggests a possible contribution of MR1 gene to the lethal process taking place in irradiated cells.

The emergence of a secondary pulmonary neoplasm at some time after the primary one raises diagnostic and therapeutic issues especially in patients with functional respiratory capacities at the limits of resectability. We present the case of a 53 years old patient which suffered a right upper lobectomy three years before for a moderately differentiated squamous carcinoma and in which a second cancer was discovered in the right main bronchus. Para-clinic explorations demonstrated the lack of local and systemic invasion of the second cancer. The optimal therapeutic way is presented and its result, discussing also the means for long term follow-up of the patients operated for non-small cell lung cancer.