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Development and testing of a questionnaire: assessment of occupational risk factors in surgeons

Thu, 01 Jan 2026 00:00:00 GMT

Title: Development and testing of a questionnaire: assessment of occupational risk factors in surgeons Authors: Vîlcova, Ana; Ferdohleb, Alexandru; Spinei, Larisa; Paraschiv, Angela; Deleu, Raisa; Ciobanu, Elena Abstract: Introduction. Surgery exposes professionals to significant physical and psychological risks, including intense exertion, prolonged static postures, and repetitive gestures, often leading to musculoskeletal pain. International studies report prevalence rates above 90%, linked to long procedures and poor ergonomics, alongside exposure to biological and chemical hazards, radiation, toxic smoke, and chronic stress. In the Republic of Moldova, occupational health in the medical sector is underexplored, with no tools tailored to surgeons. This study aims to develop and validate the first nationally standardized questionnaire to assess these risks and support public health policies. Material and methods. The study used a sequential mixed-methods design: a qualitative phase to identify domains and indicators, followed by a quantitative phase for psychometric testing. Four domains were defined: working conditions, occupational factors, general health, and psycho-emotional state. The questionnaire was refined from 70 to 47 items after expert review and validation, with internal consistency (Cronbach’s α) and content validity (I-CVI, modified Kappa) assessed. It was pre-tested on 52 surgeons, and data were analyzed using SPSS 27 (p<0.05). Results. Content validation revealed S-CVI/Ave values ranging from 0.934 to 1.00 and S-CVI/UA values from 0.738 to 1.00, with all domains exceeding the accepted threshold for relevance and clarity, except for one domain, which fell slightly below the recommended level for unanimous agreement. I-CVI values ranged from 0.857 to 1.00 (relevance) and 0.847 to 1.00 (clarity), while κ* indices were all rated as “excellent”. Based on expert feedback, 24 questions were revised and 15 were removed. Overall internal consistency was very good (α = 0.808), with section values ranging from 0.769 to 0.864, the highest being for “Psycho-emotional state” (α = 0.864). The pre-test sample comprised 52 surgeons, mostly male (57.7%), with a mean age of 44.92 years, predominantly from urban areas (92.3%). Respondents generally found the questions clear but noted some lengthy formulations, repetitiveness, and sensitive items. These observations contributed to optimizing the final version of the instrument. Conclusions. The final questionnaire meets the initial theoretical dimensions and shows strong psychometric properties, with high validity and internal consistency. The tool is comparable to established instruments and suitable for assessing surgeons’ health and occupational risks, with potential for wider use.

From prolonged premature rupture of membranes to bronchopulmonary dysplasia: the role of chorioamnionitis in the respiratory outcomes of preterm infants

Thu, 01 Jan 2026 00:00:00 GMT

Title: From prolonged premature rupture of membranes to bronchopulmonary dysplasia: the role of chorioamnionitis in the respiratory outcomes of preterm infants Authors: Dascaliuc, Liuba; Crivceanscaia, Larisa; Oclanschi, Ludmila; Revenco, Ninel; Cracea, Angela; Sârbu, Zinaida Abstract: Introduction. Prolonged premature rupture of membranes predisposes to intrauterine infection and chorioamnionitis, both of which have significant implications for neonatal outcomes. While chorioamnionitis has been linked to accelerated surfactant production and reduced respiratory distress syndrome, it is also associated with long-term pulmonary injury, including bronchopulmonary dysplasia and pulmonary hypertension. The objective of the study is to investigate the association between prolonged premature rupture of membranes, chorioamnionitis, and respiratory outcomes among preterm infants ≤34 weeks of gestation. Material and methods. A prospective cohort of 108 preterm infants admitted to the Neonatal Intensive Care Unit of the Mother and Child Institute, Chișinău, between October 2023 and July 2024, was divided into two groups: infants born to mothers with clinical/histological chorioamnionitis (n = 54) and controls (n = 54). Maternal risk factors, incidence of prolonged premature rupture of membranes incidence, Apgar scores, type and duration of respiratory support, and pulmonary complications were analyzed. Statistical significance was tested using chi-square and logistic regression. Results. Prolonged premature rupture of membranes was significantly more frequent in chorioamnionitis group (67% vs. 22%, p<0.001). Infants exposed to chorioamnionitis had lower 1-minute Apgar scores, greater need for invasive ventilation (5.9 ± 10.6 vs. 2.2 ± 4.8 days, p<0.05), and prolonged hospitalization. BPD incidence was higher in the chorioamnionitis group (25.9% vs. 3.7%, p<0.05). Mortality did not differ significantly between groups (27.8% vs. 22.2%). Conclusions. Prolonged premature rupture of membranes is strongly associated with chorioamnionitis, which in turn significantly increases the risk of long-term pulmonary complications in preterm infants. Early recognition of prolonged premature rupture of membranes, antibiotic prophylaxis, antenatal corticosteroids, and interdisciplinary obstetric–neonatal management are essential to reduce the burden of bronchopulmonary dysplasia.

Exploring the clinical spectrum of DiGeorge syndrome

Thu, 01 Jan 2026 00:00:00 GMT

Title: Exploring the clinical spectrum of DiGeorge syndrome Authors: Tomacinschii, Cristina; Sacară, Victoria; Dorif, Alexandr; Laszlo, Marodi; Șciuca, Svetlana Abstract: Introduction DiGeorge syndrome, known also as 22q11.2 deletion syndrome, is a rare multisystemic disorder characterized by a wide range of clinical features and may include thymic aplasia and subsequent immunodeficiency, conotruncal cardiac anomalies, typical facial features, palatal abnormalities, and hypocalcemia due to hypoparathyroidism. Material and methods Data were collected for 10 patients genetically confirmed with DiGeorge syndrome at the Institute of Mother and Child. This included general information, laboratory results, and clinical features. Results The mean age at diagnosis was 74.6 months (3 months – 28 years). Most cases were sporadic, with only 2 patients having a history of DGS (n=1), or close relatives with cardiac malformations (n=1). The most common symptoms that led to diagnosis were congenital heart defects (90%), and facial dysmorphism (90%). Common clinical features included recurrent infections (40%) and ENT disorders (20%). Weight was within normal percentiles for the entire group, but a delay in height growth was noted. Regarding the immunological characteristics: lymphopenia was recorded in 20% of patients, and thrombocytopenia in 2 patients. Conclusions Given the diverse array of symptoms associated with DiGeorge syndrome, physicians should be knowledgeable about both typical and less common characteristics of the syndrome to facilitate optimal treatment and potentially enable early diagnosis.

Contemporary insights into diagnosis and treatment of gastrointestinal non-Hodgkin lymphomas

Thu, 01 Jan 2026 00:00:00 GMT

Title: Contemporary insights into diagnosis and treatment of gastrointestinal non-Hodgkin lymphomas Authors: Musteață, Larisa; Robu, Maria; Musteață, Vasile; Urescu, Dumitrița; Cebanu, Irina; Capanji, Alina Abstract: Introduction. The gastrointestinal tract (GIT) is the most common site of extranodal primary non-Hodgkin lymphoma (NHL), accounting for 20% to 40% of all extranodal lymphomas. The advanced stages at diagnosis and complications remain significant issues in NHL management, imposing a substantial disease burden on patients and healthcare systems. Material and methods. We performed a descriptive cross-sectional and cohort study of patients with gastrointestinal NHL and a narrative review of the literature in the Discussion section. This study included 50 prospective and retrospective patients with NHL treated between 2015-2024 in the Institute of Oncology in Moldova. A bibliographic search was conducted using databases such as PubMed, Hinari, SpringerLink, the National Center for Biotechnology Information, and Medline. The final bibliography included 18 relevant sources deemed to be representative of the literature published on the topic of this article. Results. According to the International Clinical Classification, most patients (22, 44.0%) were diagnosed with clinical stage IV. B symptoms occurred in 38 (76.0%) patients. The overwhelming predominance of diffuse large B-cell lymphomas (46 cases - 90.2%) was observed. The complete blood count, bone marrow aspiration and biopsy of the iliac crest did not detect any specific changes in cases without bone marrow involvement, with the exception of a decrease in hemoglobin and erythrocyte counts observed in cases of posthemorrhagic anemia. The overall survival (OS) of all patients with gastrointestinal NHL was 78.1% at 1 year, 59.4% at 3 years, and 35.9% at 5 years. In patients with stage IE NHL, the 1-, 3-, and ≥5-year OS was 93.4%, 76.5%, and 69.9%, respectively. In patients with stage IIE, the OS was 91.2% at 1 year, 71.4% at 3 years, and 63.8% at ≥5 years. In patients with stage IIIE-IV, the OS was 75.1% at 1 year, 54.8% at 3 years, and 28.5% at ≥5 years with combined chemotherapy. Conclusions. Our study demonstrated that non-Hodgkin lymphomas with primary involvement of the gastrointestinal tract exhibited distinct histopathological, clinical-evolutionary and hematological features, which influenced treatment outcomes. The aggressive histological types and the advanced stages IIIE and IV prevailed within the structure of non-Hodgkin lymphomas with primary gastrointestinal involvement, and, thus, negatively impacted the survival and prognosis.