MedEspera 2018

MedEspera: The 7th International Medical Congress for Students and Young Doctors: abstract book, 2018

Mon, 01 Jan 2018 00:00:00 GMT

MedEspera: The 7th International Medical Congress for Students and Young Doctors: abstract book, 2018

Pharmacoepidemiological aspects for HIV infected patient

Mon, 01 Jan 2018 00:00:00 GMT

Pharmacoepidemiological aspects for HIV infected patient Peredelcu, Natalia Introduction. HIV produces a chronic, progressive and irreversible infection, altering the host defense mechanisms, installing AIDS and opportunistic infections, with invariable progression to death, in absence of treatment. HIV infection rapidly affects young and fertile people, who are receptive to injectable drugs use, and practicing unprotected sexual intercourse that favors the spread of the epidemic. AIDS is a global epidemic with about 40 million infected people. Twenty million people have died since the early 1980s because of AIDS-related complications. Every ten seconds, in the world, a person dies of AIDS. According to WHO, the most common cause of women's mortality worldwide is AIDS. 50% of newly infected people are aged between 15 and 25 years. At the end of 2016, 11.043 HIV-infected were registered in Moldova, and during the first nine months of 2017, 614 patients were newly diagnosed. The estimated number of all bearers is about 15 thousand citizens of Moldova. Case report. Patient M., 31 years, driver, was hospitalized with the diagnosis of HIV and many coinfections: chronic viral hepatitis B, toxic hepatitis, ascites, chronic pancreatitis, and chronic cholecystitis. Clinical picture: general weakness, periodic pronounced pain in the right side of abdomen, loss of appetite, nausea, and asthenia. Period of hospitalization: 27 days. The diagnosis was confirmed in 2009, the route of infection was sexual, but the patient also used injectable drugs. During the hospitalization he received antiretroviral treatment: Darunavir 600 mg once a day, Ritonavir 600 mg twice a day, Tenofovir + Lamivudine 1x1, and symptomatic: Mezym, Verospiron, Panangin, Furosemide, Hepasol, Sorbilact, Infusol, Hemodez, Lipesol, Arginine. The patient was discharged with the recommendation to be under the supervision of the infectious disease doctor, and to continue the antiretroviral and symptomatic treatment, repeated control over 3 months. Conclusions. HIV / AIDS is a chronic, lifelong disease without known healing, and infected people have to be medically monitored for the rest of their lives. Antiretroviral therapy aims to prolong lifetime duration and improve the quality of life of patients. Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova. The 7th International Medical Congress for Students and Young Doctors

Manual vs. mechanical anastomosis in colon resections – are there any risk factors?

Mon, 01 Jan 2018 00:00:00 GMT

Manual vs. mechanical anastomosis in colon resections – are there any risk factors? Scerbatiuc-Condur, Corina; Rotaru, Mihai; Ursu, Alexandr Introduction. Colonic resections with intestinal anastomosis are laborious interventions that require advanced technical skills. Modern technologies provide new equipment and mechanical devices for anastomosis which come to simplify the surgery. Aim of the study. Analysis of the risk factors in colon resections according to the type of anastomosis. Materials and methods. A retrospective study was made with the analysis of the patient's medical history and the operative protocols of 130 patients with colorectal resections completed with anastomosis in the PMSI IEM during 2015-2017. The postoperative evolution of patients with anastomosis was analyzed according to the time of surgery, type of anastomosis (mechanical / manual), type of continuity, location of anastomosis, duration of surgery, age of patients. Results. The results of the analysis were as follows: ratio M:F - 4:5; average age - 61.45 ± 1.3 years. 84 (64.62%) patients underwent resections with manual anastomosis and 46 (35.38%) - mechanical anastomosis (p <0.001). 74 (56.92%) patients underwent an emergency surgery, 56 (43.07%) had elective interventions, there was no significant difference between these groups. The postoperative period has evolved with anastomotic leakage in 6 (4.62%) cases: 3 (3.57%) with manual anastomosis and 3 (6.52%) with mechanical (p> 0.05). There were 5 (5.95%) leakage cases in the left colon resections - no significant difference compared to their incidence in the right hemicolectomy - 1 (2.22%). There were no significant differences in the location of anastomosis: of the rectum region 3 (7.69%), colo-colic 2 (4.28%), with ileum 1 (2%). According to the continuity of the anastomosis, two cases of leakage were observed: 6.67% in the termino-lateral anastomosis, 5.56% in the lateral-lateral and 3.13% in the termino-terminal, (p> 0.05). Age did not manifest itself as a risk factor for anastomotic fistula, 69.33 ± 4.4 years in patients with anastomotic leakage compared to 60.48 ± 1.36 in survivors (p> 0.05). Although the duration of the surgery with mechanical anastomosis was less (154.9 ± 9.14min) compared to manual anastomosis (173.47 ± 8.49min), no significant differences were observed, similar to the duration of the operation with favorable evolution compared to the cases of anastomosis dehiscence, respectively 168.53 ± 1.36min versus 140.33 ± 8.8min. 12 (9.2%) patients died. Conclusions. Although the rate of manual anastomosis significantly outweighs the mechanical ones in colon resections (p<0.001), there were no risk factors with significant difference regarding the incidence of anastomotic leakage according to the parameters analyzed. Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova. The 7th International Medical Congress for Students and Young Doctors

Approaches in the drug-induced lupus erythematosus

Mon, 01 Jan 2018 00:00:00 GMT

Approaches in the drug-induced lupus erythematosus Demenciuc, Nicolae Introduction. Drug-induced lupus erythematosus (DILE) is an autoimmune syndrome similar to systemic lupus erythematosus (SLE), caused by the long-term administration of certain drugs. The management of the disease is an important issue, because the pathogenesis and clinic manifestations of the disease have remained unclear. Aim of the study. Analysis of literature and new results regarding disease pathogenesis, clinical and laboratory manifestations, treatment and comorbidities in drug-induced lupus erythematosus. Material and methods. Selection and analysis of new literature in clinical practice, diagnostic and therapeutic approaches of drug-induced lupus erythematosus. Results. Over 80 drugs have high potential to induce DILE. The most common are; procainamide, hydralazine and quinidine. Drugs’ metabolism by the means of myeloperoxidase, their deacetylation of acetyl groups and the apoptosis with antinucleosomal antigen release are the basic links in the DILE pathogenesis. Diagnosis is made by determination of antinuclear and/or antihistronic antibodies. Most commonly used drugs for DILE control are: mycophenolate mofetil, cyclophosphamide, methylprednisolone, rituximab, belimumab, and blisibimod, indicated according to treatment schemes. Conclusions. The use of drugs must be individualized on the base of their efficacy and harmlessness. Recommended drugs in DILE treatment are prescribed according to their efficacy, accessibility, and evidence-based medicine and represent: glucocorticoids, immunosuppressants and B-cell blockade. Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova