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Background/Objectives: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by progressive impairment of neuronal transmission due to focal demyelination. The most common form is RRMS (relapsing-remitting multiple sclerosis), which, under the influence of certain factors, can progress to SPMS (secondary progressive multiple sclerosis). Our study aimed to validate the criteria proposed by a working group of the Romanian Society of Neurology versus the criteria proposed by a group of experts from Spain, Karolinska, and Croatia concerning the progression from RRMS to SPMS. Methods: This was done by gathering epidemiological data (age, gender) and by applying clinical tests such as the 9HPT (9-hole peg test), 25FWT (25-foot walk test), and EDSS (expanded disability status scale) tests and the SDMT test (symbol digit modalities test). The present research is a cohort study that included a number of 120 patients diagnosed with MS according to the McDonald Diagnostic Criteria 2017. The study was carried out between January 2023 and April 2024, including patients hospitalized in the Neurology Clinic of the Clinical Rehabilitation Hospital from Iasi, Romania. The data were collected at baseline (T0) and at a 12-month interval (T1). Results: The statistical analysis was conducted using Kaiser–Meyer–Olkin analysis, which indicated a value of 0.683, thus validating the clinical tests used. The correlation matrix and the linear regression for all the tests showed highly significant statistical results. Furthermore, the ROC curve analysis of the criteria suggested by the working group of the Romanian Society of Neurology demonstrated that the EDSS, 9HPT, and 25FWT are highly sensitive in diagnosing SPMS, an opinion that is shared with the Spanish experts, but not with the Karolinska expert panel. Using the criteria given by the Croatian expert group in the ROC curve analysis showed that only the EDSS was strongly significant for the progression to the SPMS phase. Conclusions: In conclusion, all clinical methods used demonstrated that they are valid and can contribute to identifying patients with an increased risk of progression. The model proposed by the Romanian Society of Neurology working group is similar to other countries' expert opinions and can be used to detect the risk of disease progression and establish a more tailored therapeutic management of SPMS. [ABSTRACT FROM AUTHOR]

Background and Objectives: Although available therapies have changed the natural evolution of multiple sclerosis (MS), in time some patients assume a progressive course and no longer respond to treatment. There is no definitive clinical or laboratory parameter to certify MS progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS) in early phases of transition. Our study aims to evaluate the value of clinical parameters and serum neurofilament light chain levels (sNfLs) as early warning signs of conversion to SPMS. Materials and Methods: The Expanded Disability Status Scale (EDSS), Nine-Hole Peg Test (9HPT), 25-foot walk test (25FWT) and Symbol Digit Modalities Test (SDMT) were evaluated at 12 months apart in a cohort of 83 RRMS treated patients. sNfLs were evaluated at the second time point. Results: sNfLs correlate with EDSS and SDMT, with EDSS change and disease duration. Clinical parameters correlate among themselves and perform well in supporting the diagnosis of SPMS in logistic regression and ROC curves analysis. Eighty percent of the RRMS patients in our study (of which 65% are treated with high-efficacy disease-modifying drugs) showed some type of progression independent of relapses (PIRA) after 12 months, with one in five patients experiencing isolated cognitive worsening and almost two-thirds some type of motor worsening. We found no differences in terms of progression between patients treated with platform drugs versus high-efficacy drugs. Conclusions: An elevated level of progression independent of relapses (PIRA) was found in our cohort, with high-efficacy drugs providing no supplementary protection. As sNfL levels were correlated with the progression of EDSS (the main clinical progression marker), they may be considered potential prognostic markers, but further studies are necessary to precisely define their role in this direction. The lack of early sensitive markers for risk of progression may contribute to therapeutic delay and failure. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Coexistenţa t(9;22) şi a inv(16) a fost descrisă într-un număr limitat de cazuri de LMC, LAM de novo sau LAM post chimioterapie. Raportăm un pacient cu LMC care a prezentat atât inversie de 16 cât şi cromozom Philadelphia şi care a evoluat spre criză blastică sub tratament cu Imatinib. Diagnosicul de laborator şi monitorizarea s-a realizat prin citometrie în flux, citogenetică convenţională şi tehnici de genetică moleculară. Inv(16), detectată prin cariotipare în clona Philadelphia pozitivă la momentul transformării blastice, a fost evaluată retrospective prin metoda real-time PCR, şi s-a dovedit a fi fost prezentă încă de la diagnostic. Biopsia de măduvă osoasă, efectuată în faza blastică a LMC, a confirmat prezenţa blaştilor aparţinând liniei mieloide, cu indicii de diferenţiere monocitoidă, frecvent asociată cu inv (16). De asemenea, cazul a asociat şi mutaţia F359V în domeniul kinazic al ABL, care determină rezistenţă intermediară la Imatinib şi Nilotinib, ceea ce a impus schimbarea terapiei cu Dasatinib. În cazul prezentat evoluţia a fost progresivă, urmată de deces ca urmare a lipsei de răspuns la inhibitorii de tirozin kinază, la 18 luni de la diagnosticare. Coexistenţa t(9; 22) şi inv(16) în LMC pare a fi asociată cu o evoluţie clinică agresivă şi rezistenţă la terapia cu inhibitori de tirozin kinază. Având în vedere numărul foarte mic de cazuri descrise în literatura de specialitate, deciziile terapeutice în cazul pacienţilor care prezintă aceste anomalii sunt încă dificile

Introduction: In the neuroendocrine tumors management, the accurate monitoring of the radiotracer biodistribution and tumors dimensions are vital. We have created a visual functional grading scale, which could better classify the pathological uptakes in possibly different grades. Material and method: We conducted a retrospective, bi-centric study, for a period of 18 months on 65 patients, with different types of NETs. Somatostatin receptor scintigraphy was performed using a radiolabeled somatostatin analogue. Using the Regions of Interest (ROI) technique, we defined and used a visual functional grading scale, in three degrees, qualitatively evaluating the intensity of the physiological and pathological uptake of the tracer. Results: Applying our proposed visual functional grading scale, positive 99mTc-TOC NETs lesions were identified, in all analyzed patients: 31 G1 primary NET, corrected ROI tumor values of 1.16-4.75, 19 G2 primary NETs, corrected ROI tumor values between 5-14.9 and 7 G3 primary NETs, corrected ROI tumor values between 15.65-243.79. Conclusion: Our proposed evaluation scale was useful for the interpretation of SRS for NET precision medicine and could be applicable in the evaluation of other neoplastic pathologies images. [ABSTRACT FROM AUTHOR]

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Influenza vaccination is very important not only for elderly and children that don't have enough autoantibodies that can fight against different viruses. Individuals who receive influenza vaccination have to be precautious because this immunization can determine allergic reactions for people that are sensitive to the yolk sac of the egg. The doctor has to know the allergies of the patients before vaccination. This review informs about randomized controlled studies for improving influenza. But despite all these, for receiving the flu-shot, all the patients need precautions before and after vaccination because they can develop allergies. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional study was to examine the association of supernatural beliefs and sense of coherence with death anxiety and death depression in a Romanian sample of cancer patients. We found support for the terror management theory worldview defence hypothesis postulating the presence of a curvilinear relation between death anxiety and supernatural beliefs among cancer patients. Results conformed to an inverted U-shape quadratic regression, indicating that cancer patients who scored moderately on supernatural beliefs were afraid of death the most, while death anxiety was lowest for the extreme atheists and extreme believers in supernatural entities. [ABSTRACT FROM AUTHOR]

In a world where, as a result of biological laws, there is a constant confrontation between humans and microorganisms, vaccination remains the most rational method of prevention against infectious diseases. According to the great changes occurring in modern medicine, vaccinology became an innovative science because it saves millions of lives daily. The introduction of new vaccine preparations is a challenge for both research and clinical practice, but also for health policy decidents in countries where the population is at risk for illness and death. Even if a new vaccine is used in the general population after more than 10 years of research and investment in human and financial resources, in recent years there is an increasing tendency to exploit the psychology of parents in assuming the vaccination agreement and thus the compliance to immunization campaigns decreased considerably. In this way, it is not only compromised the beneficial effect of the vaccine on one person, but virtually the benefit of collective immunity, that is provided by the immunization of at least 80% of the eligible population. The desire of controlling and sometimes eliminating and eradicating an infectious disease that can be prevented by protecting individuals becomes increasingly distant and impossible. There are many examples in the recent years, demonstrating the beneficial effects of vaccines compromised for many reasons (religious, psychological, financial) and one of them is related to the „myth” about the causal relationship between hepatitis B vaccination and multiple sclerosis. Pros and cons proved to be controversial, but what brings hope for a positive resolution in this ”dilemma” of the modern world is only the scientific argument, according to evidence-based medicine. [ABSTRACT FROM AUTHOR]

Breast cancer is the most frequent neoplasm in women worldwide and the principal cause of deaths by cancer, the majority being by metastatic disease. About half of breast tumors are hormone dependent, and in post- menopause women the preferred first line treatment uses third generation aromatase inhibitors. Aromatase is encoded by CYP19 gene on 15q21.1, and there is strong evidence that mutations in this gene affect its expression, with direct consequences on cancer phenotype and response to treatment. Several single nucleotide polymorphisms have been studied on CYP19A1 transcription variant, notably rs727479, rs10046, rs4646 and rs700518. We implemented a Taqman-based allele discrimination assay for the rapid investigation of the 4 SNPs in CYP19A1. We genotyped 22 metastatic breast cancer patients by the technique described. [ABSTRACT FROM AUTHOR]

Background: The teamwork of physicians and nurses provide an optimal condition for a patient's medical care. They both require the highest possible level of education. The Romanian universities started to educate nurses in designated specialties only a few years ago. This late start is problematic but, on the other hand, can provide the opportunity to improve the design of medical education systems. Aims and objectives: To assess the impact of inter-professional activities implemented in the education of medical students, starting with their first year of study, as part of the medical and academic policies related to modern bioethical concepts of partnership in medical practice. Design and Method: 16 skills were selected to be taught, performed, practiced and assessed in a simulation center, using a system of teaching relying on peers and work experienced nurses. A manual of protocols including an evaluation template was elaborated for this purpose. A mentoring program was implemented, and it involved nurses guiding students during the summer practice. Results and Discussion: During the academic year 2012-2013, 751 students were instructed and assessed at the simulation center. Both students and mentor nurses participating in the pilot program answered to 153 questionnaires, out of a total of 190 distributed, and these had been analyzed in order to assess various items (satisfaction with the program, feeling of usefulness, confidence and readiness to perform the necessary medical tasks, frequency in performing them etc.) that have documented a favorable experience. Conclusions: With this system of education, students have the chance to feel useful in a professional environment, confident in their skills, better accepted, involved and valued by the working medical professionals. Students, both from medicine and nursing specializations, benefit from a training program in nursing skills that includes didactic interactions in order to learn to value each other's profession and expertise and be capable of future collaboration to the benefit of patients. [ABSTRACT FROM AUTHOR]

Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.

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 Iaşi, 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.

Unlabelled: The quality of the health care system is an essential condition for in improving the quality of health services and satisfying both the patients and healthcare professionals., Research Objectives: To identify the characteristics of medical profession, the factors of professional satisfaction or dissatisfaction and health care team-related factors that influence the quality of care., Material and Methods: Qualitative study using a SurveyMonkey online questionnaire consisting of 14 open-ended questions. The respondents were 1013 health professionals in university and non-university hospitals with various unit profiles., Results: According to healthcare professionals, medical profession is defined by: humanism and personal sacrifice (33.37%) and also high professional competence (33.07%). Satisfaction factors are: patient health (40.57%), high social status (36.33) and saved lives (33.07%). Dissatisfaction may be due to: low salary (39.98%), disorganization (38.10%) and lack of procedures (33.96%). Performance may decrease as a result of: stressful working conditions, lack of adequate medical supplies, lack of recognition at work, routine, and strained relations with superiors., Conclusions: The study shows the need for correlating the medical education system and health systems, and for an integrated analysis of both systems by determining the required skills and modeling the medical team behavior in accordance with the performance variables which take into account satisfaction among both patients and health care professionals.

Aim: Marketing surveys of the health system collect useful information to develop effective management strategies. The research aim consisted in measuring patient satisfaction with health care quality., Material and Methods: The qualitative research was based on an online SurveyMonkey open-ended questionnaire. The analysis of patient satisfaction/dissatisfaction with healthcare professionals was performed in 1838 patients. Correlation analysis allowed the identification of some determinants associated with patient satisfaction., Results: The variable most commonly associated with satisfaction was "I got adequate information about procedures/treatment" according to 32.2% of respondents. The patients who were dissatisfied most commonly complained that they were "Not adequately informed about maneuvers and treatment", reported by 40.0% of respondents., Conclusions: This study provides a basis for building an original model for determining the variables of an efficient healthcare system which to ensure a high degree of patient satisfaction.

Unlabelled: Thyroid nodules are a common pathology of the thyroid gland. Thyroid fine-needle biopsy (FNB) is a technique used as the first step in the assessment of thyroid nodules. Some au- thors have demonstrated the superiority of nonaspiration compared with aspiration biopsy., Aim: The objective was to assess whether there are significant differences between the two thyroid biopsy techniques., Material and Methods: The study group comprised 309 patients with thyroid nodules admitted to the Endocrinology Clinic of the Iasi "St. Spiridon "Hospital between 2005 and 2008 in which fine-needle nonaspiration or aspiration biopsy was performed. The slides were read by one pathologist. The smears were stained using the May-Grunwald-Giemsa method (MGG). The quality of smears obtained by the two sampling techniques was evaluated by using the scoring system developed by Mair., Results and Discussion: No differences in smear quality between the two sampling techniques in terms of blood contamination, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and preservation of appropriate architecture were found., Conclusion: The results of this study show that the sensitivity and specificity of both techniques allow their use as standard screening methods for thyroid nodular lesions.

Background: Patients with gastroesophageal reflux disease (GERD), present a typical symptomatology with heartburn and regurgitations in about 80%., Objective: This study will assess the prevalence of gastroesophageal reflux disease and some demographic features of the study group. It will also be assessed the sensitivity and specificity of GERD Questionnaire and the risk factors of the disease., Material and Methods: For the current study 426 patients were selected who were admitted to a tertiary gastroenterology-hepatology hospital in Athens, Greece, complaining about having the common symptoms of GERD (heartburn and regurgitations). The study period was January 2008-March 2011. Positive diagnosis has been based on personal history, clinical examination and by upper gastrointestinal endoscopy., Results: Of 426 patients, 20 were excluded from the study. 150 (36.9%) were women and 256 (63.1%) men. The mean patient age was 48.77 years with SD 14.32 years. The age group with the highest frequency of GERD was the 40-59 years including 196 (48.3%) patients and also the group between 20-39 years including 111 (27.3%) patients. 60 (14.8%) patients were not diagnosed with GERD after following an upper gastrointestinal endoscopy., Conclusions: The M:F ratio for patients with Barrett esophagus is 5:1. The sensitivity for the diagnosis of GERD using questions about the typical symptoms (regurgitation, heartburn) is about 72.6%. Although, the prevalence of GERD is higher in males than females, the prevalence of esophagitis and GEFV grade between sexes in not statistically significant. On the other hand, there is a strong statistical significance between sex and grade of HH presence (p < 0.05).

Standard therapy in chronic hepatitis C virus infection is still a combination of peginterferon alfa2a/2b and ribavirin for 48 weeks. As of side effects, there are organic side effects, such as hematologic disorders, and functional side effects, reflected in the quality of life of hepatitis C patients. Up to 30% of the patients develop specific side effects such as headache, fever, fatigue. Sarcoidosis, known as a granulomatous disease of uncertain cause, is an uncommon finding in this category of patients. This cause-effect relation is accounted for by the convergent action of peginterferon and ribavirin of stimulating type 1 T helper cells and reducing type 2 helper T cells activation. We present the case of male patient known with chronic hepatitis C who developed pulmonary sarcoidosis following antiviral therapy. The first manifestation of the disease was unexplained fever accompanied by pulmonary tract disease. The diagnosis was established by immunophenotyping in bronchial aspirate

Aim: Based on new data, this investigation aimed at emphasizing the importance and the medical and socio-economic implications of an early diagnosis in gastric cancer., Material and Methods: The study included a series of 77 patients with gastric cancer admitted and treated at the surgical department of the Moineşti Municipal Emergency Hospital in the interval 2000-2010. Patients' data were obtained by clinical-epidemiological inquiry, laboratory and imaging investigations, and official statistical reports. Epidemiological and statistic-mathematical methods were used to process and interpret the collected data., Results and Conclusions: Hemoglobin and hematocrit levels as well as the presence of anti-Helicobacter pylori antibodies were determined by laboratory tests. Barium sulfate X-ray examination was performed in 52% of our patients; endoscopy concurrent with the histo-pathological examination of gastric biopsy samples showed that most tumors were of vegetative and ulcerative type, being prevalently located in the antropyloric area and lesser gastric curvature. Computer tomography proved to be the method of choice for tumor dissemination and staging. The late diagnosis of gastric cancer, with aggressive forms and poor prognosis, suggests the need of preventive population screening programs.

Unlabelled: Cancer is now a major public health problem by the size of the human, medical, economical and social implications as well as in industrialized and also in developing countries. Gastric cancer is a neoplasia with a starting point in gastric mucosa, representing one of the most common malignant visceral locations, being on the second most common after lung neoplasm. The aim is to highlight the incidence of gastric cancer in Emergency Municipal Hospital in Moinesti in relation with certain factors (age, sex, area of origin, personal habits, personal and family pathological history) for a period of eleven years., Material and Methods: The study has been conducted on a period of eleven years (2000-2010) and it included 77 patients with gastric cancer. The following parameters were evaluated: age, sex, area of origin, personal habits, personal and family pathological history., Results: Distribution by years of study revealed that most of the cases were in 2009 (19 patients). The incidence of gastric cancer was over two times higher at men than at women, the ratio men/women being 2.34 to 1. The most common cases (n = 40) were reported in people over 61 years (the mean age was 60.32 +/- 111.87) and from rural areas (ratio rural/urban areas = 1.5:1). Only 15 patients (19.5%) had in the personal antecedents stomach or duodenal ulcer and half of the cases were smokers (49.35%)., Conclusion: The profile of patient with gastric cancer was contoured: male, over 60 years, from rural areas, smoker and with a personal history of stomach or duodenal ulcer.

In defining new potential prognostic factors in cervical cancer, p53 protein expression, Ki67 or issues related to Bcl-2 oncogene involved in cellular apoptosis process, have been the subject of numerous publications. This paper aims to study with immunohistochemical methods, the way in which these factors are involved in influencing the prognosis of patients with cervical cancer. The study was conducted on 42 pieces operators from the same number of patients diagnosed with this disease, aged between 25-65 years and in different clinical stages. We used an experimental design type 2 (histopathological type squamous cell/adenocarcinoma) x 3 (degree of differentiation weak/ moderate/ well differentiated) x 4 (stage I/ II/ III /IV disease). Diagnosis was based on clinical examination and confirmed by histopathology, and hypothesis testing we used Kruskal-Wallis ANOVA test of ranks test, Mann-Whitney U test, chi2 test, Spearman's correlation test and crosstabs ranking difference. The results on the study group showed the prognostic value of both the proliferation marker Ki67 and p53 oncogene, the presence of tandem Ki67/p53 in cervical carcinoma meaning more so a poor prognosis, Bcl-2 overexpression was detected in none of the 42 cases investigated.

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.

Unlabelled: The aim of study was to assess some investigations in female patients with benign and malignant breast diseases., Material and Methods: The study was performed on a sample of 104 patients registered with breast tumors, at family physicians' offices from Iasi, Romania., Results: Impaired glucose tolerance was associated with 34.2% of patient with breast tumors, and hypercholesterolemia with 25.9% of them. Anatomo-pathological assessments included aspiration puncture and biopsy, extemporaneous biopsy, and paraffin-embedded exam. Invasive carcinoma was the most frequent histo-pathological type (42.1%). CONCLUSIONS; Further investigations on tumor markers are needed in all patients with in situ neoplasia and breast carcinomas.

Unlabelled: Authors present some epidemiological aspects of violent deaths in Iasi County, with certain comparisons with Romania, during the period 1997-2006., Material and Method: The study included information collected by Institutes of Forensic Medicine at the national level., Results: In Romania, violent deaths registered values between 2.6 and 4.5%, with yearly non-significant statistical differences when reported to causes of death, excepted years 2005 and 2006. Violent deaths situated Iasi County over the national level (8-11 / 2.7% per hundred thousand). Homicides registered 9.3% per hundred thousand, as compared with much more reduced values in other 12 Romanian counties, in the same period of study., Conclusions: Violent death in Romania and Iasi County highlighted a dependence of difficulties to carry out efficient programmes of prevention and emergency assistance.

Unlabelled: Assessment of quality of life requires a multidimensional measurement of health and wellness, as reported by the patient. The central objective of this research was to capture the phenomenon of impact on cancer diagnosis; disease and treatment have on physical and emotional status of patients with cervical cancer., Material and Method: The study was realized on a group of 70 patients diagnosed with this disease, aged 25-55 years and from different intellectual categories both in rural and urban. We used an experimental design of type 2 (early disease stage/advanced) x 5 (surgical therapeutic method / surgery with radiotherapy/surgery with chemotherapy/surgery with radiotherapy and chemotherapy/palliative) x 2 (low therapeutic compliance/high) x 2 (low depression/high). As data collection instruments were used histopathological examinations and psychological tests (to measure quality of life SF-36 test and test sensory and affective pain McGill and independent variables Beck Depression Scale and IPQ-R), and to verify hypotheses T test for independent samples and comparing Univariate ANOVA., Results: The results showed the importance of emotional state on the development of cancer disease and its quality of life.

Unlabelled: The authors have highlighted some aspects regarding the domestic risk and prognostic factors for different types of ovarian cancer., Material and Method: The study has included 249 women diagnosed with ovarian cancer., Results: The assessment of age group distribution of patients with serous carcinoma (150 cases) underlying that the age group of 60-69 years was more frequent compared with the other age groups (OR = 0.20; IC 95% = 0.12-0.33; p < 0.01 x 10(-5)) and the mean of age was 61 years, 8 months, 19 days (DS = 11 years, 11 months, 22 days). The most frequent risk factor for serous type was the ovulation lifetime over 30 years (78.66%); followed by early menarche (under 12 years) (13.33%); smoking (12%); late menopause (over 52 years) (10%) and hormone replacement therapy (HRT) (2.67%), compared with mucinous carcinoma for which the most frequent was the ovulation lifetime over 30 years (65.21%); followed by early menarche (under 12 years) (34.78%); late menopause (over 52 years) (26.08%) and smoking (17.39%)., Conclusions: The ovulation lifetime over 30 years was identified as the main risk factor for both histological types, but it was significant more frequent among women with serous type. Smoking was more frequent among those who had mucinous carcinoma compared with serous type. No significant differences were identified among women with both histological types regarding the age at first menstrual bleeding and parity.

Unlabelled: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the frequent causes of acute and chronic hepatitis worldwide and the leading causes for hepatic cirrhosis and liver cancer. There is a distinct geographical variation in VHB and VHC incidence in adult and child., Aim: To assess the evolution trend of VHB and VHC incidence in child, in Romania and Iasi County, during the last two decades., Material and Methods: Data were obtained using information from the Reporting National System for acute viral hepatitis A, B, and C, from various geographical areas of Romania. Some systematical errors of information were identified, without significant influence of results and conclusions., Results: Results highlighted an incidence peak of VHB in Romania, in 1989, and in Iaşi county, in 1991 (43.1, respectively 41.2 per thousand inhabitants). The VHB incidence trend decreased after the implementation of vaccination programme, especially in children < 4 years old., Conclusions: The study remarked the necessity of viral hepatitis surveillance programme continuity in Romania and the importance of prevention measures including, for VHB, an optimal vaccination.

Unlabelled: The study included information collected in the reports of Forensic Medicine Institutes, at the national level, processed and interpreted using epidemiological and biostatistical methods., Results: In Romania, at the national level, the annual values of suicide incidence increased from 18 to 30% and in 70-80% of cases, other causes led to violent death (intoxication, precipitation, submersion, burning, cut wounds, shooting a.s.o.). In laşi County, the annual values of suicide incidence varied between 1.1 and 2 per thousand inhabitants, and the main cause was hanging registered in 60.2% of cases in 31-60 age groups, with male predominance., Conclusion: Results are useful for the orientation of educational prevention programs.

Health status represents a tool frequently used for assessment of therapeutic impact of different therapeutic methods in various diseases including chronic obstructive pulmonary disease (COPD). We review the methodology of health status assessment performed with generic and disease or symptoms specific questionnaires Definition of quality of life-related terms, analysis of data from various studies on COPD using health status as an outcome measure was performed. Health status is widely used in studies assessing efficacy of both pharmacological and non-pharmacological therapeutic methods in COPD. In COPD health status can be measured with several generic or specific questionnaires and can be an appropriate efficacy endpoint in therapeutic trials.

Unlabelled: Genital cancers represent an important issue regarding women health, as they produce a large number of cases, invalidities and deaths., Aim: The evaluation of individual risks for a group of women with genital neoplasia., Material and Methods: We conducted a pilot case-control study to validate the questionnaire for the evaluation of risk factors in genital cancers, in a number of 40 female subjects (20 cases and 20 controls). We have realized the data processing using the SPSS 16 and EpiInfo 3.5.1. soft wares., Results: For questionnaire validation we have evaluated the reproducibility, the validity, the acceptability and the practicability of the questionnaire. In order to establish the test reproducibility, we have calculated k factors for inter-investigator (k = 0.34) and intra-investigator (k = 0.72) variation. To evaluate the questionnaire validity we calculated the sensitivity (cases = 94%; controls = 97%), specificity (cases = 67%, controls = 75%), positive predictive value (cases = 94%; controls = 94%), negative predictive value (cases = 67%; controls = 86%). The risk factors most frequently identified were genital infectious in clinical records (75% comparing to 52.5% - p = 0.036), and also the presence of other pathological records in genital area (65% comparing to 22.5% - p = 0.0001)., Conclusions: For an accurate identification of individual risk at women with genital cancers subsequently studies on greater number of subjects is necessary.