1. COLECȚIA INSTITUȚIONALĂ

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

2026-06-02T11:12:38Z

Development and testing of a questionnaire: assessment of occupational risk factors in surgeons Vîlcova, Ana; Ferdohleb, Alexandru; Spinei, Larisa; Paraschiv, Angela; Deleu, Raisa; Ciobanu, Elena 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

2026-06-02T10:39:12Z

From prolonged premature rupture of membranes to bronchopulmonary dysplasia: the role of chorioamnionitis in the respiratory outcomes of preterm infants Dascaliuc, Liuba; Crivceanscaia, Larisa; Oclanschi, Ludmila; Revenco, Ninel; Cracea, Angela; Sârbu, Zinaida 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.

Pharmacoresistant burning mouth syndrome: clinical patterns and treatment efficacy

2026-05-30T11:27:44Z

Pharmacoresistant burning mouth syndrome: clinical patterns and treatment efficacy Purice, Virgilia; Purice, Vasile; Bordeniuc, Gheorghe; Lacusta, Victor Introduction. Burning mouth syndrome is a form of idiopathic orofacial pain, characterized by a persistent intraoral burning sensation or dysesthesia, in the absence of obvious causative lesions. The management of this condition remains difficult, due to the heterogeneity of the mechanisms involved, the variable therapeutic response and the significant impact on the quality of life. Aim: To describe the clinical and therapeutic profile of patients with burning mouth syndrome with poor pharmacological response (pharmacoresistance). Materials and methods: The study had an observational, descriptive, case series design, and included 20 patients with burning mouth syndrome. The duration of treatment, drug classes used, reported adverse reactions, percentage of pain reduction under pharmacotherapy, VAS scores and OHIP-14 score were analyzed. Absolute and relative frequencies were calculated for categorical variables, and mean and standard deviation, median, interquartile range, and minimum and maximum values were reported for numerical variables. Results. The group presented multiple drug class use, with benzodiazepines being administered to 95% of patients, antidepressants to 85%, and topical treatments to 70%. Treatment duration was 56.4 ± 13.8 months, with a median of 59 months. Pain reduction under pharmacotherapy was modest, with a mean of 25.8 ± 4.4%, and residual pain intensity remained high, with a mean VAS score of 5.92 ± 0.37. For OHIP-14, available in 19 patients, the mean score was 28.8 ± 5.2. Tinnitus and vertigo were among the most frequently reported adverse reactions. Conclusions. The patients included in the study presented a profile characterized by long-term treatment, polypharmacotherapy, modest pain relief, persistence of pain symptoms, and significant impairment of oral quality of life. This picture reflects a limited therapeutic response and supports the need for a multimodal, individualized approach, with the integration of functional assessment and therapeutic tolerability.

Sindromul de gură arzândă farmacorezistent: tiparele clinice și eficiența tratamentului

2026-05-30T11:23:07Z

Sindromul de gură arzândă farmacorezistent: tiparele clinice și eficiența tratamentului Purice, Virgilia; Purice, Vasile; Bordeniuc, Gheorghe; Lacusta, Victor Introducere. Sindromul de gură arzândă reprezintă o formă de durere orofacială idiopatică, caracterizată prin senzație intraorală persistentă de arsură sau disestezie, în absența unor leziuni cauzale evidente. Managementul acestei afecțiuni rămâne dificil, din cauza heterogenității mecanismelor implicate, a răspunsului terapeutic variabil și a impactului important asupra calității vieții. Scop: Descrierea profilului clinic și terapeutic al pacienților cu sindrom de gură arzândă cu răspuns farmacologic deficitar (farmacorezistență). Materiale și metode: Studiul a avut un design observațional, descriptiv, de tip serie de cazuri, și a inclus 20 de pacienți cu sindrom de gură arzândă. Au fost analizate durata tratamentului, clasele medicamentoase utilizate, reacțiile adverse raportate, procentul reducerii durerii sub farmacoterapie, scorurile VAS și scorul OHIP-14. Pentru variabilele categoriale au fost calculate frecvențele absolute și relative, iar pentru variabilele numerice au fost raportate media și deviația standard, mediana, intervalul intercuartilic și valorile minime și maxime. Rezultate. Lotul a prezentat utilizarea multiplă a claselor medicamentoase, benzodiazepinele fiind administrate la 95% dintre pacienți, antidepresantele la 85%, iar tratamentele topice la 70%. Durata tratamentului a fost de 56,4 ± 13,8 luni, cu mediană 59 luni. Reducerea durerii sub farmacoterapie a fost modestă, media fiind de 25,8 ± 4,4%, iar intensitatea durerii reziduale s-a menținut ridicată, cu un scor VAS mediu de 5,92 ± 0,37. Pentru OHIP14, disponibil la 19 pacienți, scorul mediu a fost de 28,8 ± 5,2. Tinitusul și vertijul s-au numărat printre cele mai frecvent raportate reacții adverse. Concluzii. Pacienții incluși în studiu au prezentat un profil caracterizat prin tratament de lungă durată, polifarmacoterapie, reducere modestă a durerii, persistența simptomatologiei algice și afectarea semnificativă a calității vieții orale. Acest tablou reflectă un răspuns terapeutic limitat și susține necesitatea unei abordări multimodale, individualizate, cu integrarea evaluării funcționale și a tolerabilității terapeutice.