http://repository.usmf.md:80/handle/20.500.12710/7466 2026-04-09T03:46:39Z http://repository.usmf.md:80/handle/20.500.12710/16106 Title: Curierul medical. October 2013, Vol. 56, No 5 Abstract: It is a peer-reviewed and attested by National Council for Accreditation and Attestation (certificate of State registration N 1020394 from 12.03.1993), practical, a scientific journal designed for specialists in the areas of medicine and pharmaceuticals. The journal was founded by the Ministry of Health of the Republic of Moldova in 1958. Since 2005, the Nicolae Testemitsanu State University of Medicine and Pharmacy has become the co-founder of this journal. The journal publishes official papers as well as independently submitted scientific articles, editorials, clinical studies and cases, lectures, methodological guides, reviews, brief reports, and correspondences.; Este o revistă ştiinţifico-practică acreditată de Consiliul Naţional de Acreditare şi Atestare (certificat de înregistrare de Stat nr. 1020394 din 12.03.1993), destinată specialiştilor din toate domeniile medicinei şi farmaceuticii. Revista a fost fondată de către Ministerul Sănătăţii al Republicii Moldova în anul 1958. Din 2005, asociat al revistei devine Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”. Revista publică comunicări oficiale şi, totodată, sunt editate diverse publicaţii, inclusiv independente: articole ştiinţifice, editoriale, cercetări şi prezentări de cazuri clinice, prelegeri, îndrumări metodice, articole de sinteză, relatări scurte, corespondenţe şi recenzii la monografii, manuale, compendii.; Это аккредитованное Национальным Советом по аккредитации и аттестации (свидетельство о гос. регистрации № 1020394 от 12.03.1993) научно-практическое издание для специалистов всех медицинских профилей и фармацевтов. Журнал был основан Министерством здравоохранения Республики Молдова в 1958 году. С 2005 года соучредителем журнала становится Государственный Университет Медицины и Фармации им. Н. А. Тестемицану. В журнале печатаются официальные материалы, а также научные статьи (в том числе от независимых авторов), наблюдения из клинической практики, обобщающие статьи, краткие сообщения, методические указания, рецензии на новые монографии, учебники, корреспонденция и др. Description: Fondatori: Ministerul Sănătăţii al Republicii Moldova, Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu” 2013-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/13412 Title: Accelerated postoperative rehabilitation: the aeronautic model. Monograph by Adrian Belii Authors: Neamtu, Aurel; Kehlet, Henrik Abstract: “Fast-track surgery”, called later ”enhanced recovery after surgery”(ERAS) is a relatively new approach to the surgical patient and overall postoperative period. For the first time, the ERAS concept was elaborated and presented by Henrik Kehlet et al. in 1997 [1]. The essence of this concept is that a postoperative morbidity, which is not caused by the imperfect surgical technique, must be sought in the pathophysiological mechanism of the surgical stress. ERAS is based on two pylons: 1. Optimization of clinical pathways for surgical patients; 2. Canceling unnecessary “traditional” treatments and implementation of evidence-based medicine principles instead of them. So far, the ERAS concept has been tested by many teams from different countries on patients with various comorbidities and of different age, who received various types of surgery. Quasi-unanimous conclusion was that the benefits of this approach were obvious: a significant reduction in the length of hospital stay, reduced postoperative morbidity, accelerated patient’s return to homeostasis and cost reduction. ERAS concept can be easily upgraded, reconfigured and/or adapted according to various parameters: patient’s profile, type of surgery or structure of health care system. In this context, the monograph of Dr. Adrian Belii “Accelerated Postoperative Rehabilitation: the Aeronautic Model” [2] provides an original approach that improves and optimizes the perioperative management of elective surgical patients, described by H. Kehlet. From the beginning, I would like to mention the words “aeronautic model” in the title. In the past decade, hospitals tried to borrow the organizational patterns of High Reliability Organizations from nonmedical fields, for example, aviation and nuclear industry. Thus, by analogy the author analyzes functioning of an airport and hospital, where the aircraft is the patient, the crew - the medical team and the flight from point A to point B – the perioperative management and recovery. The monograph has 168 pages, contains 21 tables and 58 figures. The monograph consists of two parts: (1) medical and biological aspects of the aeronautic model of accelerated postoperative rehabilitation and (2) medical management of the aeronautic model. The first part of the monograph consists of six chapters and describes in terms of recent literature data and Dr. Belii’s personal research results the most important aspects of an ERAS protocol. Thus, in the author’s opinion, the quality of postoperative pain management is a particularly important component of “fast-track” surgery, which should rely on the following principles: self-assessment of the pain intensity, pain anticipation and association of painkillers and analgesic techniques. The author also shows that modernization of anesthetic practice shifting to computerized technology of drug delivery (target controlled infusion anesthesia) and new anesthetics provides a better anesthesia management, better adaptation to surgical stress intensity and faster emergence from anesthesia with fewer incidents. An interesting element of this monograph is the proposed ventilation weaning algorithm for the stage of the emergence from anesthesia. In the future, this could be integrated in the software of recovery room ventilators. Testing of the weaning algorithm proved the possibility of reducing the duration of lung ventilation by 40% in the patients that emerge from anesthesia. Other original ideas proposed by the author are the terms “static” and “dynamic element” related with postoperative management. “Static element” is called a treatment which does not modify in a fast and significant way biological parameters of a patient and usually has a supportive or preventive role. In contrast, “dynamic element” is called a treatment that rapidly and significantly influences biological parameters of a patient, hence adequate monitoring of vital signs is mandatory. The second part of the monograph refers to cross-cutting issues, indispensable for modern perioperative care. It refers to risk management modules and healthcare quality assurance, information flow and decision making mechanisms, optimization of the operating suite schedule in a hospital and last but not least, to economic aspects of ERAS programs. In conclusion, I would like to mention that Mr. Adrian Belii’s monograph “Accelerated Postoperative Rehabilitation: the Aeronautic Model” is an original and scientifically valuable paper which I recommend to anyone interested. 2013-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/7832 Title: Particularităţile răspândirii vectorilor şi agenţilor cauzali ai encefalitei acariene în Republica Moldova Authors: Gheorghitsa, S.; Chicu, V.; Burlacu, V.; Melnic, V.; Gutsu, A.; Caraman, N.; Gori, A.; Ternovoi, V. Abstract: The aim of the study is to determine the circulation of tick-borne encephalitis (TBE) causal agents in the Ixodidae ticks population and the evaluation of the TBE threat to public health. The species of ticks Ixodes ricinus, Dermacentor reticulatus, D. marginatus and Haemaphysalis punctata can be often met in the ecosystems of the Republic of Moldova. The species I. ricinus is the most numerous and widespread one, the fact that shows its high epidemiological significance. At the same time the species D. reticulatus, D. marginatus and H. punctata are the potential directions of TBE maintaining the TBE viruses in the environment. The laboratory results got by the enzyme-linked immunosorbent assay (ELISA) have indicated the TBE virus antigen in of 25.2% of the ticks, collected in the period of 2009-2012. Using the polymerase chain reaction method it has been established that on average the RNA of TBE virus has been 8.1% of all tested tick samples. The specific antibodies to tick-borne encephalitis virus have been identified in 9 (4%) tested human specimens. The rationalization of the system of epidemiological surveillance and control of tick-born encephalitis consists in developing and implementing a definition of the case for report on the basis of clinical and laboratory criteria, as well as the communication with epidemiological station, and studying to obtain standardized and comparable data. 2013-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/7831 Title: Analiza accesibilităţii şi satisfacţiei populaţiei Republicii Moldova la serviciile de consiliere şi testare voluntară Authors: Stratulat, S. Abstract: In the Republic of Moldova HIV infections and/or viral hepatitis counseling and testing are provided free of charge in the offices of voluntary counselling and testing (VCT) and are based both on an individual application and on the direction of the medicalstaff. Most people are sent to pre- and post-test counseling for HIV and/or hepatitis to the VCT offices by the doctors while their own initiative remains low. 60% of people have been tested on HIV markers without the pre-test counseling and their written informed consent, and about 25% of people who have got the pre-test counseling and have been tested for HIV markers do not know their test rezults. The people with high risk of infection are not properly covered with counseling by VCT offices. HIV testing based on rapid saliva tests has a limited application in Moldova. To assess the quality of the services of voluntary counseling and testing through the prism of clients’ satisfaction by these services a questionnaire to assess the level of customers’ satisfaction has been used and 967 people who were advised in these offices have been interviewed. Using the relevant statistic reports (Form №. 25 san) “The quarterly report about the activities of the VCT offices concerning HIV and viral hepatitis B and C”, approved by the Ministry of Health, the analysis of the indexes of the activities of VCT offices regarding HIV and viral hepatitis B and C in the period of 2009-2011 has been conducted. 2013-10-01T00:00:00Z