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Prin tematica pe care o abordeaza, lucrarea este destinata tuturor persoanelor care sunt interesate de problematica fiscala din Romania, managerilor financiari, studentilor si masteranzilor, angajatilor din institutii publice, persoanelor care exercita profesii libere, care vor sa-si imbogateasca cunostintele in domeniul fiscalitatii si contabilitatii.Fiecare capitol al lucrarii cuprinde obiectivele avute in vedere, parte teoretica, cuvinte si expresii cheie, aplicatii rezolvate, probleme propuse spre rezolvare. Consider ca lucrarea poate fi un indrumar pentru consultantii fiscali si expertii contabili.

The most studied VEGF molecule is VEGF-A (Vascular Endothelial Growth Factor). Its involvement in various neoplastic processes represents an intensely controversial hypothesis.This is a prospective study extending over a period of 7 months, and including 38 hospitalized patients who underwent surgery for gastric cancer between 01/01/2011-07/01/2011, at the Surgery Departments of the Emergency Clinical County Hospital Mureş. Survival rate was determined based on age and gender of the patients, the macroscopic and microscopic appearance of the tumor, and pT, N, M parameters of the resected specimens. All these tumor parameters were correlated with preoperative VEGF-A levels, measured at the Central Laboratory of the Emergency Clinical County Hospital Mureş, using plasma samples and a human VEGF ELISA kit with cross-reactivity with VEGF 165 (BioLife Group), according to the instructions provided by the manufacturer. No enrolled patient had any preoperative treatment. In order to establish the reference value for VEGF-A in serum, we tested a group of 14 apparently healthy persons, and we calculated a mean value.The reference value for VEGF-A in serum was 157.3 pg/ml. In gastric cancer patients the preoperative VEGF-A levels were 376, 188 +/- 247.11, showing significant elevation vs. the control group (p0.001), but it did not correlate with any of the tested tumor parameters. Survival rate displayed statistical correlation with histological type of the tumor, and VEGF-A serum levels, so that patients with intestinal type gastric cancer showed a superior survival vs. those with diffuse type (p = 0.0043). A better survival was noted in patients with VEGF-A serum levels over the threshold value of 173 pg/ml.The VEGF-A levels in serum are significantly increased preoperatively in gastric cancer patients, compared to apparently healthy persons, but they do not show correlation with tumor parameters. As a result it cannot be used as prognostic factor, but it may be an evolution marker. Survival rate is significantly higher in intestinal type gastric cancers, ads compared to the diffuse type, as well as in patients with serum VEGF-A values over the threshold value.

In the performed study we investigated the main risk factors in dental decay occurring.The method was a transversal inquiry, with a specific questionnaire applying and registration of the patients' data in 10 dental selected offices, from TimiSoara, during the year 2005. The material of study consisted in a sample of 60 patients with dental decay, homogenous and statistical representative, which were diagnosed and treated in the dental offices.The obtained results pointed out the following aspects: predominant age group of dental decay was 15-20 years; in the first 7 years of life 90% of patients did not receive medication for dental decay prophylaxis; 23% patients consumed daily sweet food and 46% consumed acid food; 66% patients performed daily and twice per day oral hygiene. The average of index DMF (Decay Missing Filled) increased proportionally with the frequency and type of sweet food consumption (DMF was 40% for daily consumption and 42% for chocolate and other sticky sweets, respectively). Acid juices consumption was associated with increased DMF (40%). For a decreased DMF (11%) an oral hygiene of 3 times per day is necessary.Sweet, acid food consumption and improper dental hygiene are related with DMF index.

Tetralogy of Fallot represents one of the most frequent congenital heart disease in medical practice and a "corner stone" of any paediatric surgical team due to great anatomic and functional variability and clinical aspects. This paper presents a retrospective study of surgical experience in patients with tetralogy of Fallot admitted in Paediatric Cardiovascular Centre of Târgu Mureş, Romania, between 2005, October to 2009, January.There where retrospectively studied medical records of patients who undergo a surgical procedure: age, morphologic diagnosis, symptoms and type of surgical procedure, intraoperative data, postoperative follow-up and complications.In this period 110 cases of tetralogy of Fallot were operated, 81 total surgical repair (54 primary and 27 secondary procedures); also there were performed 29 "palliative" procedures: systemic/pulmonary shunts (eg. Blalock-Taussig). No intraoperative deaths were recorded; the percentage of in-hospital mortality was 1.8%.It's ideal to perform total primary repair of tetralogy of Fallot, especially in the first year of life; extreme cases (severe hypoplasic pulmonary arteries, emergency cases) benefit from "palliative" procedures. Surgical repair of Fallot tetralogy can be performed, with good results in specialised paediatric cardiac surgery centres. This paper represents the first Romanian clinical study on a large number of patients with tetralogy of Fallot surgically treated.

In the performed study we investigated alcohol consumption--a frequent risk behavior that occurs in teenagers. The institutionalization of children from disturbed family could be a facilitator factor for alcohol consumption. A new group with different habits of the members is created and the information exchange could be useful or noxious.A transversal inquiry, with CORT (Comportamente cu Risc la Tineri--Risk Behaviors in Young People) questionnaire applying in a sample with 64 teenagers, which live in an Investment Center from Lugoj. We selected 16 items referring to alcohol consumption and the social environment.Obtained results showed frequent alcohol consumption in the social environment (group of friends--85% and disorganized family--debut of alcohol consumption under 8 years in boys group). The places of alcohol consumption are bars, restaurants (73% boys), in the Investment Center (59% boys and 29% girls), in the friends' houses, on the street. They consume alcohol in group and alone. The boys became drunk frequent (20% affirmed that became drunk more than 40 times in the last month). Discontent about relation inside the group increases the alcohol consumption outside the group.The alcohol consumption as a learned behavior in the origin disorganized family could be disseminated in the Centers for Children Protection.

The treatment of aortic dissections type B Stanford using endovascular stents represents one of the newest advances in the treatment of this diseases, less invasive alternative to classic surgical repair. Aortic stent-grafts initially were used in treatment of abdominal aortic aneurysms, and then to treat aneurysms, dissections and traumatic ruptures of the descending aorta, with good early and mid-term outcomes. Thoracic aortic aneurysms are frequently diagnosed in mid-age or elderly patients who have arterial hypertension, coronary artery disease, chronic obstructive pulmonary disease. Scientific data reveal a two-year mortality rate of70% in untreated patients, most deaths occurring due severe haemorrhages secondary aneurysm rupture. Development of endovascular techniques is naturally, due to the inherent complications of surgery in the distal thoracic aorta (paraplegia, renal failure, stroke). Endovascular deployment of stent-grafts in the treatment of Stanford B aortic dissections represents a possible and quite safe procedure. There is a continuous debate in medical literature about the best therapeutic decision in the treatment of extensive aortic dissections. We present a case of an extensive dissection of thoraco-abdominal aorta in a 55 years old hypertensive patient treated with an aortic stent-graft. Angiograms performed at the end of the procedure revealed complete occlusion of thoracic dissection, abdominal dissection remains untouched. One and three months post procedural evaluation showed a good follow up, with partial thrombosis of abdominal dissection without renal failure or ischaemic events.

The aim of the present study performed in a Romanian population was to identify the food which can be either associated with or protect against colorectal carcinoma.Correlation and regression analysis were used to examine the association between dietary intake and the rate of incidence for colon, rectum and anus cancers, in study groups from 7 regions of Romania.A strong and positive association was observed for colonic cancer and the intake of coffee, tea and cocoa (r = 0.77, p = 0.042) whereas statistical significance of borderline value was found for margarine (r = 0.73, p = 0.06) and sweets (r = 0.74, p = 0.066) intake. A potential protective effect can be attributed to wine consumption ( r = -0.75, p = 0.03). The malignancies of the rectum and anus showed both a strong positive correlation with the intake of red meat ( r = 0.76, p = 0.048), sausages ( r = 0.87, p = 0.012), margarine (r = 0.97, p = 0.0004), butter ( r = 0.76, p = 0.049), sweets ( r = 0.93, p = 0.003), beverages (r = 0.97, p = 0.0003), coffee, tea, cocoa ( r = 0.94, p = 0.002). Negative correlations were reported for the recto-anal cancer and the consumption of: fish (r = -0.8, p = 0.032), cheese (r = -0.9, p = 0.006), wine (r = -0.85, p = 0.015).The need for reducing the dietary intake of margarine, red meat, sausages and sweets while the beneficial effects of wine consumption have been also confirmed.

An important feature of the pathophysiology of COPD patients is represented by the remodelling of pulmonary vasculature. Within this process, a pathogenic element might be the endothelial dysfunction induced by the combined effect of several factors such as: cigarette smoke, inflammatory mediators, hypoxia, mechanical stress, whose contribution differs according to the stage of the disease. The aims of our study were to characterize the structural pulmonary vascular abnormalities present in smokers and patients with mild COPD and to assess their pathophysiological importance. Serial tissue sections from fragments of pulmonary exeresis have been subjected to both morphometric analysis and histochemical examination of muscular pulmonary arteries. Our results have shown a process of arteriolar muscularization and intimal thickening of small muscular arteries in both smokers (intimal index 23.11% +/- 3.04%) and patients with mild COPD (25.62% +/- 3.06%) as compared to controls (17.86% +/- 2.96%). Correlation analysis has demonstrated that intimal thickening is significantly associated with cigarette consumption expressed as packs-years (r = 0.65, p = 0.04) whereas univariate regression has shown a moderate causal relation between the intimal collagen deposits and the degree of vascular thickening (r2=0,53 and p=0,002). In conclusion, cigarette smoking may play a central role within the pathogenesis of vascular abnormalities in patients with mild COPD.

Haemostatic hysterectomies have been performed for the first time in the XIXth century to reduce the increased maternal mortality and associated morbidity. In Romania the main cause of death through direct obstetrical risk (DOR) is the haemorrhagic syndrome, with a value of 45% of the total number of deaths in the last 15 -16 years, a lot higher then the world average of 25% as evaluated by OMS. Among the deaths due to hemorrhagic syndrome 43% is held by antepartum haemorrhage (placenta praevia, utero-placental apoplexy) and 42% by postpartum haemorrhage.In the past 15 years (1990 - 2005) there have been studied 53,870 births, out of which only 60 have had haemostatic hysterectomy, representing 0.11% of the total number of births. The prevalence of haemostatic hysterectomy is only 1 in every 883 births as a result of surgical teams' efforts to preserve the uterus. The placental pathology (30%) is responsible for most of haemostatic hysterectomy indications. Out of 60 cases under study, none ended with maternal death, while 11 cases ended with fetal death (intrapartum or postpartum).Morbidity and maternal death can be reduced by effective prenatal care, by identifying high risk patients and by the possibility of caesarean section. Haemostatic hysterectomy remains, in essence, a life saving procedure!

Nosocomial infection occurs in the hospital and other medical offices and expresses any disease, that affects the patient due to hospital admission or the received care, the activity of the medical personnel, no matter that symptoms appear or not in the hospital or outside. In the performed study we proposed to investigate the implementation level of the measures of nosocomial infections prophylaxis in dental office. The study consisted in a transversal epidemiologic inquiry through a specific questionnaire applying in a sample of 50 patients treated for dental diseases in the dental office. The items refer to the implementation level of the prophylaxis measures in the dental office. The obtained results revealed a proper patients' addressing at dental office and some deficiencies of the personnel medical activity in dental office, such as : does not wear the surgery gloves and mask, does not use the salvo vacuum for patients protection. Also, we find out a deficient medical education referring to hygiene conditions in dental office. In conclusion, there are deficiencies of the prophylaxis measures in dental office.

The dental transposition is an eruption anomaly, which occurs in this process towards the final stage and that represents the switching of 2 teeth that are next to each other. The tooth that most often is involved in transposition is the canine tooth, most frequently the upper one, which switches places either with the first premolar either with the lateral incisor. Under a clinical aspect, the transposition can be total (complete) or partial (incomplete), the latter reported both for crowns and roots. The clinical manifestation of the anomaly imposes the characteristic signs and the individualized therapeutical attitude. The dental transposition must be differentiated within the eruption anomalies from the transmigration, which defines the displacement of a tooth inside the bone beyond the median line, this tooth usually being the lower canine. Our study, which was conducted on a small group of 34 patients, shows the results of the analysis of the anomaly versus the gender, the type of the transposition, the affected maxillary etc.

In the effected study we investigated the feeding quality in Baile-Herculane, during the period 2003-2004. The study was realised in two samples consisted in 659 preschool children (55% girls and 45% boys) and 359 children (65% girls and 35% boys) respectively, homogenous and statistical representative. The method consisted in feeding investigation using based on food lists consulting, effected 2 times in a year, in the winter season (November) and in the spring season (April). The inquiry period was 10 days consequently, in each season. We had established the nutritive value of feeding portions in two months (November and April), counted the average of the nutritive ration for the both investigated periods and compared them with nutritional necessity established for the same age group. We investigated the menu structure and diversity. In the first period of feeding investigation (November 2000) we established a decreased intake of foods which determine a small intake of calories, proteins, minerals and vitamins under the nutritional necessities. In April the nutritive value of the consumed food was less than in November. The decreased consumption of milk, cheese, eggs, vegetables and fruits determined a less intake of calories, fats, minerals and vitamins than nutritional necessities. The increased intake of bread, cereals and meat caused increased values of carbohydrates, vitamin B1 and iron. The menu was divided in two meals and a snack (breakfast - 15%, snack - 15%, lunch 50%). The menu variation and courses' succession were in line with the hygienic-sanitation rules.

In the following study we've proposed to realize a comparison between the results obtained from two previous studies, regarding to smoking in 17 years of age adolescent population from Timisoara, along 10 years, in the period 1994-2004. We've revealed that the presence of this behavior is real in both studies and the trend is in an ascendant evolution. Compared with the boys, the girls have an increased tendency of daily smoking and smoke a greater number of cigarettes per day.

In the study we wanted to reveal the distribution of the food borne diseases in Timisoara county, in the period of time 2002-2003. As material we used a sample formed from 142 patients with admissions in the "Victor Babeş" Infectious Diseases Hospital Timişoara, Romania, and the method, epidemiological longitudinal descriptive inquiry, consisted in data registration of the primary evidences (observation files) of the patients. The obtained results revealed: the greater incidence of the food borne diseases in male than female sex; the highest incidence at the age group 15-44 years; the main causal agent as Salmonella group D followed by group B; the greatest frequencies of the food borne diseases in the areas Lipova, Circumvalatiunii and Students Complex of Timişoara. As conclusion, it can be affirmed that food borne diseases are a problem for Timisoara, and for the most cases the causal agent has not been identified.

One of the factors limiting the duration of rat liver storage is the excessive accumulation of catabolites in the perfusion medium. In view of obtaining of an efficient depuration the authors have introduced a new circuit allowing for the concomittant perfusion of the liver and of the kidneys. The excretion effort of the kidneys is assessed by the estimation of urea nitrogen in the perfusion medium and in the urine collected over the entire duration of the experiment. The results have confirmed the good function of the system which provides possibilities for improved storage conditions of rat liver.

Comparative studies were performed, of changes of serum proteins and IgG, IgA and IgM immunoglobulins in workers exposed to silicogenic dust. Depending on their response to tuberculin testing (2 U of PPD) these subjects were classified in negative and hyperergic. In both groups there was found a decreased albumin concentration in the serum and high alpha-2 globulin. In hyperergic subjects there was noted a slight increase of beta globulins and a significant rise in the titer of gammaglobulins. Immunoglobulins G showed a significant rise in hyperallergic subjects and slightly decreased in tuberculin negative ones, without attaining a level of immunologic deficiency. In both groups IgM immunoglobulins were significantly lowered, while IgA immunoglobulins were occasionally increased, although there was no positive correlation with tuberculin allergy. In three cases there was a slight IgA deficiency.

The author's aim was to investigate conservation of rat liver by continuous perfusion of the isolated organ in conditions of normal temperature, as well as in hypothermia. A complex solution was used, lacking hemoglobin. Over a period of 5 hours of conservation the authors evaluated the perfusion rate, the concentration of lactate and pyruvate in the conservation medium, while on histological preparations was investigated the formation of fibrin deposits in the intra-hepatic vessels. The results confirmed the positive effects of hypothermia, that is not due exclusively to a limiting of the metabolic necessities of the organ but also to a reduction of the fibrinogenesis and a slowing down of the formation of intra-hepatic microaggregates.