http://repository.usmf.md:80/handle/20.500.12710/254 2026-07-20T13:13:53Z http://repository.usmf.md:80/handle/20.500.12710/33484 Title: Emergency care for trauma patients in the red zone: clinical experience from 2024 Authors: Malacinschi-Codreanu, Tatiana; Rezneac, Larisa; Habach, Raed; Ciubotaru, Eugenia; Mocanu, Natalia Abstract: Background. The traumatized patient with signs of shock remains a major cause of morbidity and mortality, requiring rapid diagnosis and multidisciplinary management. This study evaluates clinical, paraclinical, and therapeutic aspects of trauma patients admitted with shock signs in the red zone of the Emergency Department of the Institute of Emergency Medicine during 2024. Material and methods. A prospective analysis of 60 polytrauma patients in shock was performed. Demographic data, trauma mechanisms, Glasgow Coma Score, vital signs, imaging, emergency interventions, and outcomes were evaluated. The patients were managed according to an experimental protocol developed at the institutional level, which provides for a multidisciplinary approach to the traumatized patient. This protocol was developed based on the international protocol for Advanced Trauma Life Support. It will later be implemented at the institutional level. Results. The cohort included 79% males, with a mean age of 49.7 ± 15.2 years; 75% urban residents. Grade III and IV shock were diagnosed in 40% and 28.3%, respectively. Causes of trauma included physical aggression (29.5%), road traffic accidents (28.5%), and accidental trauma (21.0%), falls from height (21.0%). Radiological lesions were detected in 63.3%, positive findings on Focused Assessment with Sonography for Trauma in 40%, and cranial lesions identified by computed tomography in 60%. Intraglotic intubation was required in 80% of patients, vasopressor support was administered in 50%, antibiotic therapy in 95%, and emergency surgery was performed in 30%. Mortality was 1.7%. Conclusions. Protocol-driven multidisciplinary care facilitated effective stabilization of traumatized patients presenting with shock. Early diagnosis, the use of advanced imaging techniques, and timely therapeutic interventions significantly contributed to improved patient outcomes. These findings underscore the critical role of structured trauma life support protocols in emergency medical settings. 2026-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/33483 Title: The iCREATE registry: a model for strengthening injury surveillance in the Republic of Moldova Authors: Cazacu-Stratu, Angela; Cociu, Svetlana; Marga, Patricia Maria; Cartaleanu, Dumitru; Dulf, Diana; Cebanu, Serghei Abstract: Introduction. Injuries represent a major public health issue, causing approximately 16,000 deaths globally each day (10% of all deaths), which is 32% more than the combined total caused by malaria, tuberculosis, and HIV/AIDS. Over the past 15 years, the WHO and regional initiatives have supported the piloting of trauma registries in low- and middle-income countries as essential tools for monitoring, planning, and prevention. Objective. This article aims to assess the feasibility and utility of implementing a national trauma registry in the Republic of Moldova, in order to improve injury surveillance and emergency service planning. Materials and methods. In 2018, the pilot iCREATE trauma registry was tested for the first time in three countries: Moldova, Armenia, and Georgia. The data collection instrument was developed based on WHO recommendations, ICD-10, and IDB-JAMIE standards under the guidance of partners from the University of Iowa and Babeș-Bolyai University, Cluj-Napoca. All trauma cases from the Institute of Emergency Medicine and the Valentin Ignatenco Municipal Clinical Children’s Hospital in Chișinău were included in the registry. Results. The analyzed sample consists of 7,942 individuals, predominantly male (57.3%). The most represented age groups were 19-29 years (17.8%) and 30-39 years (17.6%), while individuals aged 70 and above accounted for 11% of the total. Most incidents occurred in urban areas (76.9%). Of the total patients, 52.4% were treated and discharged, while 37.5% required hospitalization. Injuries occurred primarily at home (55.4%) and on public roads (24.7%). The leading mechanism of injury was falls (68.2%), followed by other causes (12.2%) and cut/pierce injuries (10.0%). The most frequently affected body regions were the head/skull (12.5%) and knee (11.8%), followed by the hip (6.7%) and wrist (6.4%). Fractures were the most common injury type (34.5%), followed by contusions (23.0%) and open wounds (14.7%). Several gaps in data collection and reporting were identified and should be considered in future efforts to enhance trauma surveillance. Conclusions. The data highlight the need to develop a national trauma registry as an essential tool for monitoring, prevention, and effective intervention, alongside health promotion campaigns targeting vulnerable groups and the involvement of relevant stakeholders. 2026-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/33445 Title: Micronutrient needs and supplementation strategies during pregnancy Authors: Cemortan, Maria; Sagaidac, Irina; Cernețchi, Olga Abstract: Introduction. Micronutrient deficiencies during pregnancy remain a major global public health concern, with implications for maternal health, fetal development, and long-term child outcomes. International organizations such as the WHO and FIGO have issued evidence-based guidelines on micronutrient supplementation, which are increasingly being adapted into national protocols. Material and methods. This narrative review was based on literature searches in PubMed, Scopus, Web of Science, and Google Scholar, covering January 2000 to May 2025. Peer-reviewed studies, systematic reviews, and clinical guidelines from WHO, FIGO, and the Moldovan Ministry of Health were included. The review focused on iron, folic acid, iodine, calcium, vitamin D, and selected trace elements. Results. Iron and folic acid emerged as the most consistently recommended supplements across guidelines, with proven efficacy in reducing maternal anemia and neural tube defects. Iodine and calcium are also emphasized, particularly in regions with documented dietary insufficiency. Moldova’s antenatal care protocol largely aligns with WHO and FIGO recommendations, prioritizing targeted over universal supplementation for nutrients beyond iron and folate. Evidence on routine supplementation with multivitamin complexes remains inconclusive. Conclusions. Evidence-based micronutrient supplementation is essential to optimizing pregnancy outcomes. Universal iron and folic acid supplementation remain the cornerstone of antenatal nutrition strategies. Conte 2026-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/33432 Title: Developing and validating a questionnaire on knowledge and attitudes in health research ethics Authors: Paladi, Adriana; Mîța, Valentin; Șaptefrați, Lilian Abstract: Introduction. Research ethics and integrity are fundamental for safeguarding human participants and ensuring trustworthy scientific practices. Understanding researchers’ knowledge, attitudes, and perceptions regarding ethical standards is important for all health researchers, but particularly relevant for early-career researchers. While several international instruments exist to evaluate specific aspects of research ethics, such as plagiarism, organizational climate, or responsible conduct of research, a multidimensional and contextually relevant tool is required. Materials and methods. A comprehensive questionnaire was developed to assess ethical knowledge, attitudes toward research resources and institutional integrity measures, and self-perceived ethical competencies among doctoral students in the health sciences. Item formulation was guided by international standards, including the Declaration of Helsinki, the European Code of Conduct for Research Integrity, and Good Clinical Practice guidelines. The development process included a content validity assessment by 10 experts and a psychometric evaluation of the collected data from 274 doctoral students. Exploratory factor analysis (EFA) was applied to determine the latent structure of the questionnaire, and internal consistency was assessed using Cronbach’s alpha. Results. EFA revealed a six-factor structure explaining 64.5% of the total variance. The factors measured: (I) perceived importance of research resources, (II) self-perceived ethical competencies, (III) implemented institutional measures for research integrity, (IV) ethical principles and moral responsibilities, (V) perceived accessibility of research resources, and (VI) importance of institutional integrity measures. Factor loadings were generally high, and internal consistency was good to excellent, with Cronbach’s alpha values ranging from 0.738 to 0.989. These findings indicate that the questionnaire captures multidimensional aspects of research ethics and integrity. Conclusions. The developed questionnaire represents a robust, valid, and reliable instrument for assessing ethical knowledge and attitudes among researchers in health sciences. It can serve as an internal audit tool to evaluate research integrity climate, researcher satisfaction with available resources, and implementation of institutional policies. Moreover, it provides a foundation for designing targeted training programs and professional development initiatives aimed at improving ethical competencies. 2026-01-01T00:00:00Z