http://repository.usmf.md:80/xmlui/handle/20.500.12710/12314 2026-04-12T17:56:11Z 2026-04-12T17:56:11Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/16515 2021-09-23T07:44:39Z 2019-01-01T00:00:00Z

The Moldovan Medical Journal. March 2019, Vol. 62, No 1 The Moldovan Medical Journal is an international scientific double-blind peer reviewed periodical edition, 4 per year, of the Scientific Medical Association of the Republic of Moldova designed for specialists in the areas of medicine, dentistry, pharmacy, social medicine and public health. From its debut the journal has striven to support the interests of Moldovan medicine concerning the new concepts of its development. The Editorial Board warmly welcomes both the readers of and the authors for the journal, all those who are enthusiastic in searching new and more effective ways of solving numerous medicine problems. We hope that those who want to make their contribution to the science of medicine will find our journal helpful and encouraging. Fondatori: Ministerul Sănătăţii al Republicii Moldova, Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”

2019-01-01T00:00:00Z Severin, Ghenadie http://repository.usmf.md:80/xmlui/handle/20.500.12710/6765 2021-09-23T07:44:53Z 2019-01-01T00:00:00Z

Postoperative cognitive dysfunction: physiopathological aspects and clinical evidence Severin, Ghenadie Background: Postoperative cognitive dysfunction (POCD) represents a decrease of cognitive abilities (memory, learning, concentration), which develops in the postoperative period after a variable amount of time (days or weeks). Today, the pathogenesis of the POCD development is not fully known. Literature suggests multiple possible mechanisms of POCD development. Certainly, the neuro-inflammatory effect (generated by the surgery itself) from the cortical zones responsible for learning and memory, is one of the phenomena frequently noted in these patients. This article is a narrative synthesis of literature on postoperative cognitive dysfunction – a quite spread phenomenon found in patients during postoperative care. We described suggested theories and the pathophysiological mechanisms involved in the development of this clinical condition. Its incidence according to different types of surgery is presented. We reviewed the available tools for identification and qualitative assessment of postoperative cognitive dysfunction, including biomarkers. Also, we discuss the risk factors for postoperative cognitive dysfunction and their role in clinical decision making process. Conclusions: Postoperative cognitive dysfunction is a common complication after the surgery. It occurs in frail patients or in individuals presenting general risk factors. It looks like there is a genetic predisposition for the development of postoperative cognitive dysfunction. Patients at risk of postoperative cognitive dysfunction can be identified by neurocognitive testing tools. Valeriu Ghereg Department of Anesthesiology and Reanimathology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova

2019-01-01T00:00:00Z Cirjau, Elena Behta, Emilia http://repository.usmf.md:80/xmlui/handle/20.500.12710/6764 2021-09-23T07:48:15Z 2019-01-01T00:00:00Z

The role of cytomegalovirus in the development of opportunistic infections Cirjau, Elena; Behta, Emilia Background: About one century ago, was found and described a new virus, which, due to its particular way of damaging cells, was called cytomegalovirus. Human is the only natural source of cytomegalovirus infection. The relevance is that it is a widespread pathology, and due to its ability to “disguise” in the human body, remains unnoticed until the “defect” appears in the body’s immune system. It is especially dangerous for pregnant women, children and people with immunodeficiency. It is one of the most common infections that cause pathology in the fetus and newborns, which, in turn, leads to serious consequences, from disability to child death. There are many ways of cytomegalovirus transmission: airborne, parenteral, domestic contact, sexual and vertical (transplacentally, with aspiration of secretions from the birth canal and natural feeding). The virus is able to have a direct and indirect effect on the body. It is able to independently induce immunosuppression. The article describes the epidemiological data, pathogenesis, clinical manifestations, and modern methods of diagnosis, treatment and prevention of cytomegalovirus infection. Also, some diagnostic problems in immunosuppressive organisms are described. Conclusions: Due to its consequences, namely, children`s disability, death and immunosuppressed people, cytomegalovirus has become a demographic problem. A high infection frequency indicates a low level of social development of the population. More public awareness is needed on the transmission and possible consequences of cytomegalovirus infection. Department of Microbiology and Immunology, NicolaeTestemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova

2019-01-01T00:00:00Z Fala, Paula Cojocaru, Ina Chetrari, Larisa Gavriliuc, Pavel Sangheli, Marina Lisnic, Vitalie http://repository.usmf.md:80/xmlui/handle/20.500.12710/6763 2021-09-23T07:48:38Z 2019-01-01T00:00:00Z

Lambert-Eaton myasthenic syndrome – a misdiagnosed condition Fala, Paula; Cojocaru, Ina; Chetrari, Larisa; Gavriliuc, Pavel; Sangheli, Marina; Lisnic, Vitalie Background: Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder of the neuromuscular junction. Clinical features include proximal muscle weakness, markedly in the lower limbs, reduced deep tendon reflexes that can increase after exercise, and autonomic disturbances. The clinical picture as well as knowledge of the laboratory test that accompany LEMS will permit early recognition of the disease, that is crucial because it is often associated with malignancy, especially small cell lung cancer (SCLC). In this article we present a patient with proximal muscle weakness and typical changes on repetitive nerve stimulation, as well as a short literature review on the topic. Conclusions: The diagnosis of LEMS is usually made on clinical grounds. The diagnosis is confirmed by electrophysiological testing, main features including decrement response on slow repetitive nerves stimulation (3Hz), and an increment of more than 100% in CMAP amplitude after brief exercise, or high frequency repetitive stimulation (30-50 Hz). Immunological panel assay with positive P/Q-type VGCC antibody is strongly suggestive of LEMS. While symptomatic treatment with 3,4 – diaminopyridine is available, one of the main priorities is evaluation for underlying malignancies in these patients, the most common being SCLC. Evaluation of patients with LEMS and no known cancer should start with CT of the chest, abdomen and pelvis. Brain imaging is recommended if focal neurological signs are present. If the initial evaluation of the patient is negative, repeated screening for malignancy after 6 months and up to two years is recommended. Department of Neurology No 1, Nicolae Testemitsanu State University of Medicine and Pharmacy, Department of Neuromuscular Disorders and Polyneuropathies, Institute of Neurology and Neurosurgery, Chisinau, the Republic of Moldova

2019-01-01T00:00:00Z