http://repository.usmf.md:80/handle/20.500.12710/20919 The 9th International Medical Congress for Students and Young Doctors, May 12-14, 2022 2026-04-11T02:29:23Z http://repository.usmf.md:80/handle/20.500.12710/21396 Title: MedEspera 2022 : The 9th International Medical Congress for Students and Young Doctors, 12-14 May 2022 : Abstract Book 2022-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/21394 Title: Heart rate variability in people with personality disorders in the pain test Authors: Ceban, Dinu Abstract: Introduction. The main features of each personality disorder (PD) are emotional disorders. The median prevalence in the population of Borderline personality disorder (BPD) was estimated at 1.6%, but may reach 5.9%. The increased incidence of cardiovascular disease associated with psychiatric pathologies has also led to increased attention to the autonomic nervous system. BPD with an increased rate of cardiovascular mortality, and characterized by emotional instability, is ideal for studying heart rate variability (HVR). Aim of study. The purpose of the study is to determine the autonomic changes in people with BPD by studying the HRV both at rest and in the pain test. Methods and materials. The study involved 95 people, 19 to 60 years old, using the Personality Inventory for DSM-5 (PID-5), all subjects were divided into 2 groups: control group (n = 64) and group of people with BPD (n = 32). The experimental protocol included the recording using the BIOPAC MP-36 Data Acquisition System of the electrocardiogram in the second standard lead in 3 functional periods: Resting (R) - 5 min, Pain test (pain stimulation) (PT) - 3 min and Post-pain test period (post PT) - 5 min. The primary data processing was performed with the help of the program Kubios HRV Standard (version 3.2.0, 2019). The spectral analysis Fourier of the RR interval was applied and following parameters have been analyzed – normalized low frequency component (LFnu) and normalized high frequency component (HFnu). Results. In subjects with BPD, higher HFnu values are observed at rest, highlighting an amplified vagal modulation of the heart rhythm, and a lower sympathetic influence on the heart rhythm. During the pain test, a decrease in the vagal activity and an increase in the sympathetic activity on the heart rate were observed in both groups. In the post-pain test period, LFnu and HFnu values in subjects with BPD were reversed compared to resting period, which indicates an increase of sympathetic influences on the heart rate and a reduction of vagal modulatory effects. The LFnu and HFnu values in these subjects did not return to the initial values in the post-pain test period as they did in the control group, but, on the contrary, an increase in the dynamics of the sympathetic influence was registered, even compared to the pain test period. Conclusion. The results present an increased vagal modulation in subjects with BPD at rest, which is reduced during pain stimulation and does not return rapidly to the initial value after removing the pain stimulus. This could be the proof of the inertia of autonomic influences in these subjects, which is in concordance with the results of the studies in the research papers regarding HRV. 2022-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/21393 Title: Glycated albumin – a better glycemic control marker than HbA1c in pregnancy and gestational diabetes mellitus Authors: Bolocan, Valeria Abstract: Introduction. Since glycation of various proteins is increased in diabetes, glycated proteins can be used as glycemic control indicators. Despite being the gold standard of glycemic control, HbA1c does not precisely reflect the actual status of glycemic control in some conditions including pregnancy and gestational diabetes mellitus (GDM). In comparison, glycated albumin (GA) more accurately reflects changes in plasma glucose because it is not affected by variable haemoglobin concentrations and modified erythrocyte life span that naturally occur in pregnancy. Aim of study. Hyperglycemia that develops during pregnancy and disappears after giving birth is now recognized as a special type of diabetes, called GDM. GDM is a common medical complication of pregnancy, and the prevalence of undiagnosed hyperglycemia and even the incidence of diabetes in young women is constantly increasing. Therefore, new glycemic control markers are being investigated in order to ensure a good quality of diabetes care before, during and after pregnancy. Methods and materials. To achieve the proposed goal, a synthesis of the literature published from 2009 until 2021 has been made, using 11 bibliographic sources, including electronic libraries like PubMed, Medscape, Diabetes Care and Diabetologia. Results. Normally, erythropoietin and erythrocyte production is increased during normal pregnancy, which contributes to the understanding of the increased erythropoiesis on the one hand, and reduced haemoglobin concentration on the other hand. All of those explain the reduced life span of the erythrocytes that will determine a decrease in HbA1c values. Besides, in the first trimester there is a lower pre- and postprandial blood glucose values, which also causes a decrease in the percentage of HbA1c. Instead, in the third trimester there is an increase in the postprandial blood glucose values, which determines an increase in HbA1c. These assertions suggest that, in order to ensure an optimal glycemic control, it is mandatory to use HbA1c references specific for each trimester. Compared with HbA1c, GA reflects the short-term status of glycemic control (around 2-3 weeks). Additionally, GA reflects postprandial plasma glucose more accurately than HbA1c, which is important for the evaluation of plasma glucose level at a time point closer to the time of consultation with the physician. Moreover, as it has already been mentioned, GA does not interfere with increased erythropoiesis and erythrocyte life span, the states present in pregnancy. Conclusion. Poor glycemic control can be associated with a higher incidence of perinatal maternal-infant complications. Regardless of its major clinical importance, HbA1c is not suitable for monitoring glycemic control in pregnant women with diabetes and GDM. It has become clear that GA, another indicator of glycemic control, is not influenced by the limitations of HbA1c and therefore might be a better indicator of glycemic control in patients with GDM and pregnant women with diabetes mellitus. However, further largepopulation studies are necessary in order to confirm these findings. 2022-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/21391 Title: Gene therapy in some genetic diseases Authors: Junbei, Mircea Abstract: Introduction. Gene therapy it's a complex of methods that treats at least 10% of the approximately 9,000 genetic diseases recorded. Genetic diseases involve all dysfunctions that include deficiencies, absence or surplus of certain genetic information. Gene therapy is a complex of treatments that comes to complete the deficiency or lack of genes indispensable for the proper living of patients with an active disease. Gene therapy is a relatively young field and thus an expensive one in production, therefor today some of the drugs (for ex.: Nusinersen, Zolgensma, etc.) can reach from 325 thousand $ to 725 thousand $ a year, any target disease of gene therapy that has a huge degree of specificity and personalization. Approved treatments with a considerable degree of success are: Duchene amyotrophy (DMD), spinal muscular dystrophy (SMA), central nervous system cancer - glioblastoma; and also some therapies that need to be approved for treatment: various forms of hemophilia, Wiskott-Aldrich syndrome, diabetic retinopathy, corneal neovascularization, cancer, etc. Aim of study. Gene therapy techniques include the direct introduction of substituents into the intercellular space in the body through viral vectors - in-vivo such as: adeno-associated, adenoviral, retroviral, lentiviral vectors, etc. as well as non-viral vectors, for example: CRISPR-Cas9, introduction of plasmids, techniques such as: exon skipping, antisense oligonucleotides, also ex-vivo techniques such as introducing of modified cells, like CAR T. Some obstacles have already been overcome, for example the immune response has been partially resolved, enough to achieve the treatment, by combining it with immunomodulatory treatment with corticosteroids. Individualized forms, such as the degree in a spinal amyodistrophy type I-IV manifestation, are already coordinated with the amount of gene 2 copy. Methods and materials. The paper was based on a review of the literature, using textbooks and articles published in electronic sources recognized by the international medical community as: PubMed, NEJM, NCBI, GeneCards. Also, two clinical cases of two children suffering from Duchenne progressive muscular dystrophy and belt-shaped muscular dystrophy that could benefit from gene therapy in the Republic of Moldova were described. Results. During the study it was observed that gene therapy has widely started to be used in various diseases: cardiovascular, neuromuscular, oncology, ophthalmology, etc. Disappointing that in both clinical cases, costs of treatment are too high for the patients, this remains to be the main obstacle. Conclusion. Gene therapy has a promising future in solving incurable diseases, by proposing a new way of treatment through the involvement in genetic pathophysiology and creation of cells. This encourages medical scientists to include new diseases in research and develop new ways, more accessible to production. 2022-01-01T00:00:00Z