Bulletin of the Academy of Sciences of Moldova. Medical Sciences

Academic congratulation on the occasion of the 80th anniversary of the founding of the Nicolae Testemițanu State University of Medicine and Pharmacy of the Republic of Moldova.

2025-12-16T09:53:20+02:00

Dear colleagues, distinguished professors, researchers, physicians, pharmacists, students, and alumni,
On this beautiful anniversary—the 80th anniversary of the founding of the Nicolae Testemițanu State University of Medicine and Pharmacy of the Republic of Moldova—I extend my sincere and warm congratulations to the entire academic, scientific, and professional community who, through perseverance, dedicated work, and commitment, have contributed to the development and strengthening of our institution’s prestige.

This event marks not only a historical milestone, but also a reaffirmation of the University’s indisputable value—a leading institution of higher education in our country and a model of tradition, quality, excellence, innovation, and devotion to the ideals of the profession.

Over the past eight decades, Nicolae Testemițanu USMF has trained more than 51,000 healthcare professionals who have promoted with dignity the name of their Alma Mater at home and around the world. We have built a national medical school grounded in scientific evidence, solid training, a humanistic spirit, and social responsibility.

With profound gratitude, we acknowledge the contribution of all those who have built, supported, and continue to develop our university: founders, professors, researchers, clinicians, alumni, and national and international partners.

Today, more than ever, we are called upon to preserve the spiritual and scientific heritage of our predecessors, to strengthen academic prestige, to innovate the educational process, and to orient research and medical practice toward progress and the well-being of society.

I thank you all for your constant contribution, team spirit, and efforts to keep Nicolae Testemițanu USMF among the elite institutions. I wish you health, inspiration, academic achievements, and the joy of being part of this outstanding professional family.

Many fruitful years to you, distinguished academic and medical community!
Vivat, Crescat, Floreat the Nicolae Testemițanu State University of Medicine and Pharmacy of the Republic of Moldova!

With highest consideration,
Rector of Nicolae Testemițanu USMF,
Emil Ceban, MD, PhD, Dr. Habil., University Professor,
Corresponding Member of the Academy of Sciences of Moldova.

Official congratulation on the occasion of the 80th anniversary of the founding of the Nicolae Testemițanu State University of Medicine and Pharmacy of the Republic of Moldova.

2025-12-16T10:39:18+02:00

With deep respect and profound gratitude, we extend our most sincere congratulations to the faculty, researchers, physicians, residents, and students of the Nicolae Testemițanu State University of Medicine and Pharmacy on the occasion of a venerable anniversary-the 80th anniversary of the founding of this institution fundamental to medical science and the health of the nation. For eight decades, Nicolae Testemițanu USMF has been not only a stronghold of higher medical education, but also a center of excellence in scientific research, biomedical innovation, continuing professional development, and the promotion of humanistic values in medical practice. This anniversary provides an opportunity to honor the memory of those who laid the foundations of the national medical school in times of trial, as well as those who, generation after generation, have built the institution’s prestige with dedication, intellect, and sacrifice. With every graduating class, every valuable scientific contribution, and every life saved, the University fulfills its noble mission in the service of life. Today, the University is recognized nationally and internationally for its high academic standards, its extensive network of scientific collaborations, and its active role in strengthening the healthcare system of the Republic of Moldova. In this jubilee context, we wish to express the appreciation and gratitude of the academic and scientific community to all generations who have shaped the destiny of this institution. We wish you, dear colleagues, health, perseverance, vision, and the strength to carry forward the ideals of medicine and science in the spirit of excellence, dignity, and responsibility to society. Happy anniversary, Nicolae Testemițanu USMF! Glory to Alma Mater! With highest consideration, Ion Mereuță, Editor-in-Chief of the journal Bulletin of the Academy of Sciences of Moldova. Medical Sciences, University Professor, Dr. Habil. of Medical Sciences, Corresponding Member of the Academy of Sciences of Moldova, President of the Medical Academy “Gheorghe Țibirnă”, Vice President of the Association “Parliament of Independence”, Honored Figure, Knight of the Order of the Republic.

PI-RADS score and risk stratification in prostate cancer: clinical, imaging, and histological correlations

2025-12-17T10:06:16+02:00

Prostate cancer is one of the most common neoplasms diagnosed in men. PSA testing is an important step in early detection; however, multiparametric MRI assessment using the PI-RADS score provides a more accurate risk stratification and directly correlates with histological aggressiveness. The aim of this study was to evaluate the performance of the PI- RADS score in detecting clinically significant prostate cancer and to analyse its relationship with clinical and histological parameters.A retrospective analysis included 143 patients who underwent prostate biopsy and multiparametric MRI evaluation. Analysed parameters included age, PSA, prostate volume, PI-RADS score, and Gleason score. For PI-RADS ≥4, sensitivity was 90%, specificity 84%, and AUC 0.93. An inverse correlation was found between prostate volume and cancer probability, as well as a significant association between the PI-RADS score and Gleason grade. Combining PI- RADS with PSA density may improve risk stratification and reduce unnecessary biopsies.

Depression and qulity of life in women of reproductive age in the context of surgical menopause

2026-01-10T12:55:15+02:00

Introduction: Surgical menopause, resulting from hysterectomy with or without oophorectomy, leads to a sudden hormonal deficiency that may negatively impact the mental health and quality of life of women of reproductive age. The aim of the study was to analyze the evolution of depressive symptoms in correlation with the quality of life in reproductive-age women after the onset of surgical menopause. Methods: A prospective study involving 150 women divided into three groups: hysterectomy with oophorectomy (L1A), hysterectomy without oophorectomy (L1B), and a control group (L0). Depression and quality of life were assessed at four time points: preoperatively, at 10-12 days, and at 6 and 12 months postoperatively using the Beck Depression Inventory and WHOQOL-BREF. Results: At 12 months, depression was observed in 72% of women in the L1A group and 68% in the L1B group, compared to 16% in the control group. A statistically significant association was found between depression and reduced quality of life, particularly in the L1B group. Conclusions: Hysterectomy in reproductive-age women has a negative impact on mental health and quality of life.Integrating psychological counseling and active follow-up into pre- and postoperative care is recommended.

COVID-19 pneumonia: Correlations between bacterial co-infections, clinical and radiological parameters

2026-01-12T11:16:39+02:00

The COVID-19 pandemic created a global health crisis, affecting millions of individuals.After the onset of respiratory symptoms and the identification of viral DNA, the evaluation of patients with COVID-19 includes radiological examinations, the disease extension can be estimated through scores corresponding to the percentage of expansion of pulmonary opacities. The aim of the research was to evaluate the correlation between bacterial co-infections, laboratory parameters and the degree of lung damage expressed by the Brixia score in the context of COVID-19 disease. We conducted a prospective study that included 144 adult patients diagnosed with COVID-19 by Ag or RT-PCR test. On chest X-ray, pneumonia was established in 78.5% of cases, the predominant radiological changes being the accentuated pulmonary pattern with presence of “ground glass” opacities (53.5%). Bacterial associations were isolated in 35.7%, the Chi-square test result demonstrating a weak and statistically insignificant association in relation with the degree of lung damage (χ2 = 1.818, p = 0.178). Hematological parameters, C-reactive protein and ferritin did not demonstrate significant correlations, only band neutrophils showed an increasing trend according to the Brixia score, but a weak one (ρ = 0.348, p = 0.009). Regarding the level of procalcitonin, the results are statistically insignificant (ρ = -0.001, p = 0.998). Bacterial co-infections, isolated in over a third of cases, did not demonstrate a correlation with the degree of lung damage. The severity of lung damage is not associated with hematological and inflammatory parameters, only band neutrophils showed a slight increase trend according to the Brixia score.

Modern Therapeutic Approaches in Stroke - The Experience of the Republic of Moldova

2026-01-14T10:55:33+02:00

Stroke is a major public health problem both globally and in the Republic of Moldova, where incidence and mortality have been consistently higher than the European average. The evolution of the stroke healthcare service in the Republic of Moldova represents an example of systemic transformation, based on collaboration between clinicians, researchers, authorities and international partners. The creation of the national network of stroke centers, the significant increase in thrombolysis and thrombus extraction rates, as well as the reduction of critical intervention times, reflect premises for improving patient prognosis and reducing the socio-economic impact of this devastating pathology.

Assessment of breastfeeding support practices in maternity wards in the Republic of Moldova

2026-01-19T10:04:21+02:00

Exclusive breastfeeding during the first six months of life is internationally recognized as essential for the health of both the child and the mother. In the Republic of Moldova, as in other countries in the region, there are discrepancies between official recommendations and practices in the field, influenced by factors such as type of birth, medical support, and access to accurate information. The purpose of this study was to analyze mothers’ experiences regarding childbirth, infant feeding, and the support provided by medical staff in maternity wards. Methodology. The study was based on responses to an online questionnaire, which sought to collect opinions and experiences regarding the application of the principles of the „Baby-Friendly Hospital” Initiative, promoted by the World Health Organization and UNICEF. The tool assessed: the characteristics of childbirth, how the child was fed in the first 6 months, and the support and information received from medical staff regarding breastfeeding. The data were analyzed descriptively, using frequencies and proportions. Results . Analyzing infant feeding in the first 3 months, it was found that only two-thirds of infants (64.9%) were exclusively breastfed. A quarter of mothers (25.7%) combined breastfeeding with formula, and a smaller proportion (9.4%) fed their babies only formula. Between 3 and 6 months, the proportion of exclusive breastfeeding increased to 70.3% of cases, while 18.9% of mothers continued with formula only, and 10.8% maintained a combination of breastfeeding and formula. In terms of support in the maternity ward, 35.1% of mothers did not receive help with the correct positioning and attachment of the baby to the breast, 13.5% received the incorrect recommendation to breastfeed at fixed intervals (every 2-3 hours), 12.2% of mothers did not receive any advice on breastfeeding frequency, and 29.7% of mothers stated that they did not receive any information on the duration of a breastfeeding session. Conclusions. The study suggests the need to standardize breastfeeding recommendations to ensure consistent and evidence-based information, continuous training of medical staff in maternity wards, especially in practical techniques to support mothers, and the promotion of clear and uniform policies that could contribute to increasing the duration and quality of breastfeeding in the Republic of Moldova.

ALGORITHM FOR MONITORING PHYSICAL AND PUBERTAL DEVELOPMENT IN CHILDREN WITH CHRONIC DISEASES

2026-01-20T10:38:46+02:00

Children with chronic diseases frequently present growth disorders and delayed puberty, complications that negatively impact general health status and quality of life. Aim of the study: to elaborate a diagnostic algorithm for endocrine comorbidities in pediatric chronic diseases, using juvenile idiopathic arthritis as a model.According to the study design, children with juvenile idiopathic arthritis were included, in whom growth parameters, pubertal development, and endocrine function were assessed using age and sex - specific percentiles. The investigations comprised anthropometric indices, Tanner staging, hormonal analyses, and ultrasound, integrated with clinical disease activity scores. Based on the obtained results and current literature data, a structured algorithm for auxological and pubertal monitoring was developed.The study confirmed that growth delay, delayed or abnormal puberty, and endocrine comorbidities are frequent in children with chronic inflammatory diseases. Significant correlations were identified between growth velocity, pubertal progression, hormonal profiles, and disease activity. The proposed algorithm integrates anthropometric, pubertal, endocrine, and imaging evaluations, allowing early detection of developmental disorders and supporting individualized management.Conclusions: The algorithm provides a practical framework for the systematic evaluation of physical and pubertal development in children with chronic diseases. Its implementation may improve early detection of growth and endocrine disorders, support therapeutic decisions, and optimize the long-term prognosis.

Areas of developmental disorders in young children based on the guide for monitoring child development

2026-01-21T11:14:54+02:00

More than 200 million children under the age of 5 in low and middle - income countries (LMICs) fail to reach their full developmental potential during early childhood. Global estimates of the prevalence of global developmental disorders (GDD) range from 1-3%, but recent reports indicate a much higher prevalence (6.4%) among children in Turkey and 8% in the United Arab Emirates, and GDD are reported to be 30% more common in boys than girls.Purpose of the study: assessing the applicability of the Child Development Monitoring Guide (CDMG), identifying risk factors and determining the spectrum of developmental disorders in young children, in order to improve their monitoring interventions. Material and methods . The study included a retrospective analysis of 97 children hospitalized in the Institute of Mother and Child, between October 2024 and February 2025. The assessment of developmental disorders was carried outaccording to the instructions and criteria established in the Child Development Monitoring Guide. The assessment of the nutritional status of the children included in the study was carried out based on the determination of the body mass index (BMI), as a validated method for the analysis of the proportionality between weight and height.Conclusions . Following the assessment of the development of the children included in the study, we found the presence of significant impairments in multiple areas of development. Thus, 38.14% of the children presented disorders in the field of play, highlighting difficulties in manifesting intellectual behaviors appropriate to their age. Fine motor skills were affected in 29.90% of the children, and gross motor skills in 49.48%, indicating disorders in coordination and motor control. Regarding language development, an impairment was found in 56.70% of cases for the expressive component and in 35.05% for the receptive one, indicating delays in verbal communication both at the level of expression and comprehension. The area of social interaction was compromised in 35.05% of children, reflecting difficulties in establishing and maintaining future social relationships. At the same time, 28.87% of children presented disorders in self - care skills, indicating problems in personal autonomy.

Standardized presurgical evaluation in drug-resistant epilepsy

2026-01-23T11:14:50+02:00

Introduction: Drug-resistant epilepsy (EFR) affects approximately one-third of patients diagnosed with epilepsy and is associated with considerable morbidity. Epilepsy surgery is an effective therapeutic option but requires rigorous presurgical evaluation to ensure proper candidate selection and to minimize functional risks. Aim of study: To provide a comprehensive synthesis of the standardized presurgical evaluation stages in drug- resistant epilepsy, with a focus on the integration of noninvasive and invasive techniques for accurate delineation of the epileptogenic zone and protection of eloquent cortical areas. Materials and Methods: We performed a literature review of relevant studies and guidelines encompassing the four phases of presurgical evaluation. The specific value, diagnostic accuracy, and limitations of each method were analyzed in the context of constructing the epileptic network hypothesis. Results: Multimodal integration of clinical, neuroimaging, and neurophysiological data enables precise localization of the epileptogenic zone in over 70% of selected cases, significantly improving the likelihood of curative surgical outcomes. Functional invasive mapping plays a key role in reducing postoperative morbidity in surgeries involving eloquent cortex. Conclusions: A standardized, stepwise, and individualized presurgical evaluation is essential in managing drug- resistant epilepsy. Careful application of available methods allows for optimal surgical candidate selection, ensuring afavorable balance between therapeutic efficacy and functional safety.

Some particularities of quality of life in patients with chronic hepatopathies

2026-01-24T23:54:12+02:00

Quality of life (QoL) in medicine means the physical, mental and social well-being, as well as the patients’ ability to perform the usual tasks in their daily existence. Chronic hepatopathies are accompanied by a variety of somatic, psychological and social problems, which affect the patient’s QoL.The aim of the study: to study quality of life indices in patients with chronic hepatopathies in the Republic of Moldova. There were 59 patients with various chronic hepatopathies: 34 patients with chronic hepatitis B virus infection (CHVI-HBV group), 25 patients with steatotic liver disease associated with metabolic dysfunctions (SLDAMD group) and 26 apparently healthy individuals (control group). The SF-36 questionnaire was used to assess QoL. The lowest levels of QoL integral parameters were appreciated in the CHVI-HBV group: Physical Health Index (PH) - 46.69±1.22, Mental Health Index (MH) - 38.97±1.56 points. In the SLDAMD group PH were 47.02±1.37 and MH - 45.91±1.55 points. In the control group, the average values of PH - 53.01±0.91 and MH - 51.51±1.50 (р<0.01 with both study groups). The analysis of the results after the scores parameters reflects the maintenance of diminishing values trend in the CHVI-HBV group. PH scores of QoL demonstrate a weaker decrease. The SF-36 questionnaire can be used in patients with liver pathology; in chronic hepatopathies most QoL indicators decrease, with more severe damage in the mental component; in most patients with chronic hepatopathies the quality of life is affected, being more pronounced in liver diseases of viral origin.

Clinical - evolutionary correlation with oxidative stress parameters in community - acquired pneumonia in patients with obesity

2026-01-29T09:16:09+02:00

Community - acquired pneumonia and obesity are two clinical nosologies that are highlighted by a high incidence and prevalence worldwide. Obesity influences both the balance of oxidative status and the clinical course of community - acquired pneumonia. The aim of the study was to evaluate the clinical course correlation of community - acquired pneumonia with oxidative stress markers in obese patients. A prospective cohort study was conducted, which included 210 patients divided into two groups: group 1 - 105 patients with community - acquired pneumonia and obesity and group 2 - 105 patients with community-acquired pneumonia of normal weight. The results of the study demonstrated that obese patients presented more pronounced clinical data and more expressive prooxidant markers compared to normal weight patients.

Risk factors and key points in cardiogenic shock

2026-01-30T10:59:58+02:00

Cardiogenic shock is an acute, complex, and multifactorial syndrome caused by severe cardiac dysfunction leading to low cardiac output and tissue hypoperfusion. Identified risk factors (RFs) include: age >75 years, female sex, anterior or extensive acute myocardial infarction (AMI), angina pectoris, peripheral vascular disease, ejection fraction (EF) <30%, mitral regurgitation, and diabetes mellitus. Early diagnosis, advanced hemodynamic monitoring (HM) using PiCCO, identification of mortality-associated RFs, and guidance of fluid and vasopressor therapy are key points in CS management with a major impact on reducing mortality. The aim of our study was to assess mortality-associated RFs in CS and demonstrate the benefit of advanced HM via PiCCO in optimizing treatment and improving outcomes. Out of 86 analyzed parameters, we identified: 6 common RFs for both groups (PiCCO and ECHO): NT-proBNP >4N, acute pulmonary edema, cerebral edema, troponin >2N, total bilirubin >4N, creatinine >2N; 7 PiCCO-specific RFs: VO₂ <100 ml/min, DO₂ <250 ml/min, coma, right ventricular AMI, ERO₂ >60%, PaCO₂ >50 mmHg, hemoglobin <9.0 g/dL; 9 ECHO-specific RFs: hepatomegaly, oliguria <30 ml/h, pyelonephritis, transmural AMI, hepatic failure, stroke, inferior and anteroinferior AMI, lactate >2 mmol/L. All patients with ≥5 RFs (PiCCO group) and ≥7 RFs (ECHO group) died (100%). Male patients had a higher mortality rate (35.8% vs. 26.4%). PiCCO monitoring enabled individualized guidance of fluid and vasopressor therapy, early detection of cardiogenic pulmonary edema, and differentiation from non-cardiogenic forms. Mortality was significantly lower in the PiCCO group compared to the ECHO group (36.5% vs. 62.3%, p=0.0112).

Borderline ovarian tumors: evaluation of clinical, imaging, and morphological diagnostic methods

2026-01-30T23:19:22+02:00

Borderline ovarian tumors (BOTs) represent a distinct subtype of epithelial ovarian neoplasms, with features intermediate between benign and malignant tumors. This retrospective-prospective study, conducted between 2010 and 2024, included 156 patients diagnosed with BOTs at the Institute of Oncology and “Nicolae Testemițanu” State University of Medicine and Pharmacy. The evaluation included clinical examination, imaging, serum tumor markers (CA-125,CA19-9, CEA), histopathological analysis, and immunohistochemical profiling (Ki-67, p53, ER, PR).Results revealed a predominance of serous forms (70.5%) and a high incidence of BOTs in women under 50 years of age. The CA-125 marker was elevated in 64.7% of cases and positively correlated with tumor stage. Immunohistochemical analysis showed high expression of ER, PR, p53, and Ki-67. The mean tumor size was 14.12 cm, and bilateral localization was observed in 41.7% of patients. The study supports the need for an integrated and personalized diagnostic algorithm to optimize oncological management and preserve fertility in selected patients.

Structural changes of the pituitary gland related to neonatal conditions: a pilot study and literature review

2026-01-31T19:59:16+02:00

The pituitary gland is a key endocrine organ involved in the regulation of neuroendocrine functions. However, its morphology during childhood remains poorly documented, with fragmented data in the worlwide literature and almost no studies in the local context. This paper aims to analyze morphological aspects of the infant pituitary gland by correlating existing literature data with histological observations from a series of pediatric autopsy cases. Morphological analysis was performed on standard hematoxylin and eosin-stained sections. Changes observed in both the adenohypophysis and neurohypophysis are described, highlighting structural particularities during the neonatal period. The study provides preliminary observations regarding cellular distribution, tissue maturation, and potential influences of neonatal pathology on pituitary architecture. The conclusions contribute to a better understanding of normal pituitary development and possible morphological deviations during childhood.

Bronchoscopic diagnosis in bronchopulmonary cancer

2026-02-01T13:30:46+02:00

Videobronchoscopy is an essential investigation for the diagnosis of bronchopulmonary cancer. It can highlight the tumor developed inside the bronchus, provides information about its location, offers the possibility of biopsy material sampling, TNM staging, evaluation of tumor extension and operability, and surgical intervention. The possibilities of diagnostic fibrobronchoscopy were evaluated in 208 patients with bronchopulmonary cancer. Diagnostic fibrobronchoscopy was performed under general anesthesia with supraglottic airway intubation. The article describes the changes detected by flexible videobronchoscopy in patients with central and peripheral lung cancer, the results of cytological and histological analysis, as well as the complications established during videobronchoscopy.

Management of the diagnosis of esophageal cancer

2026-02-02T13:13:23+02:00

Early detection of esophageal cancer is vital, as it provides a significant increase in the chances of survival. Establishing the diagnosis of esophageal cancer is achieved by using a variety of methods that provide important data about the presence and location of the tumor, the growth pattern and spread of the neoplasm, the morphological structure and staging of the cancer for the establishment of a treatment plan.

What is hidden after Acute Coronary Syndrome?

2026-02-03T10:29:09+02:00

Stress (“Tako-Tsubo”) cardiomyopathy or Takotsubo syndrome (TTS), is characterized by acute but rapidly reversible LV systolic dysfunction in the absence of atherosclerotic coronary artery disease, triggered by strong psychological, physical or iatrogenic stress. Takotsubo syndrome is a complex and still poorly recognized heart disease with a wide spectrum of possible clinical presentations. Despite its reversibility, it is associated with serious adverse in-hospital events and high complication rates during follow-up. Multimodal imaging is helpful for establishing the diagnosis, guiding therapy, and stratifying prognosis of TTS patients in both the acute and post-acute phase. This article describes the clinical case of a 67 - year - old woman who, after a strong emotional stress, presented with clinical manifestations of ACS. Following laboratory tests and investigations (ECG, Echocardiography, Chest X-ray, Coronary angiography, Ventriculography) the diagnosis of Takotsubo Syndrome was established. Based on treatment with beta-adrenoblockers, anticoagulants, dual antiplatelet therapy (Aspirin+Clopidogrel), nitrates, statins, metabolic drugs (Mildronate), the patient’s condition improved, with the recovery of left ventricular systolic function.

Application of some physiological indicators for the diagnosis of overweight in patients with chronic hepatopathies

2026-02-04T10:35:39+02:00

Overweight and obesity are global public health problems associated with a high risk of chronic diseases, including hepatopathy. Pre-obesity is considered a transitional state between normal body weight and obesity, requiring timely diagnosis and correction. A total of 591 patients with diffuse liver diseases were examined. The following were formed: group I (gr.) - 177 patients with BMI <25, group II - 228 with BMI 25-30, group III - 186 with BMI>30. BMI, visceral fat, waist circumference and upper arm circumference were assessed. BMI in group III - 34.21±0.32 kg/m², in group II - 27.62±0.12 kg/m², in group I - 28.52±0.18 kg/m². - 23.20±0.19 kg/m². Visceral fat in group III - 15.19 ± 0.39%, in group II - 10.63 ± 0.25%, in group I 7.46 ± 0.27%. Waist circumference in group III - 112.23±0.82cm, in group II - 99.32±0.61cm, in group I - 89.62±0.73cm. Shoulder circumference in group III - 35.16 ± 0.34cm, in group II - 31.66 ± 0.31cm, in group I - 28.64 ± 0.30cm. Pre-obesity in patients with chronic hepatopathies is accompanied by significant changes in anthropometric parameters. Simple measurements such as waist and shoulder circumference can serve as informative markers in assessing nutritional status.

Morphofunctional disorders of erythrocytes in obese patients with SARS-CoV-2 infection

2026-02-05T22:25:19+02:00

Introduction. Individuals with obesity and COVID-19 were more likely to have metabolic disorders. Objective: To identify morphofunctional changes in erytnrocyte MCH and RDW indicators, serum levels of red blood cells and ferritin in obese patients with COVID-19. Material and methods. The examined 44 patients: men - 27 (61.62%), women - 17 (38.8%), mean age 55.16±4.5 years were divided into 4 groups: Group I (n=9) patients with body mass index (BMI) 30 - 34.9 kg/m², Gr. II (n=8) - BMI35-39.9, Gr. III (n=10) with BMI>40 kg/m² and comparison group (Gr.k) (n=17) patients with COVID-19, with normal weight. The degree of obesity was determined by BMI (body mass index) - the ratio of body weight in kilograms to the square of height in meters (kg/m²).Results obtained. Erythrocytes were found in Gr.I - 4.67±0.16, p≥0.05 in Gr. II - 4.82±0.1 p≤0.05, in Gr. III - 4.82±0.2, p≥0.05, compared to Gr.k - 4.68±0.13 (106/ul), RDW index was maximally increased in Gr. III - 13±0.3, p≤0.05, in Gr. II - 12.7±0.13, p≤0.01 in Gr. I - 12±0.3, p≤0.05, compared to Gr.k - 12.15±0.14 (%). MCH index - in Gr. I - 28±0.6, p≤0.01, in Gr. II - 26±0.3, p≤0.001 and in Gr. III - 24.0±0.8, p≤0.001 compared to Gr.k - 30.4±0.5 (pg). There was a tendency to increase serum ferritin levels - in Gr. I - 455±18.3, p≤0.05, in Gr. II - 468±18, p≤0.01, been higher in Gr. III - 551±11.4 ng/ml, p≤0.001 compared to Gr.k - 447.4±18.4 (ng/ml.).Conclusions. The results of the studies confirm the presence of morphofunctional disorders of erythrocytes and erythrocyte indices with an increase in serum ferritin in obese hepatic patients with Covid-19 directly proportional to the increase in body mass index.

The impact of second line antiretroviral treatment on viral load and immune status in patients with HIV/AIDS.

2026-02-05T23:56:48+02:00

HIV/AIDS infection remains a major public health problem globally and in the Republic of Moldova. After treatment failure, switching to second-line ART is essential for infection control and immunological recovery. We aimed to evaluate the impact of second-line ART on viral load dynamics and immunological status in patients with HIV/AIDS who have failed first-line therapy. The retrospective-prospective study included a group of 101 HIV-positive patients, monitored during 2014-2020 at the “Toma Ciorbă” Clinical Hospital for Infectious Diseases in Chisinau. Diagnosis and surveillance were performed using serological and molecular genetic methods (PCR), and immunological status was assessed by flow cytometry. Clinical and laboratory parameters were monitored longitudinally, at the initiation of second-line ART and subsequently at 1, 2 and 3 years of treatment. The selection of therapeutic regimens was individualized, depending on comorbidities, adverse reactions and potential drug interactions. At the initiation of second-line ART, 59.4% of patients had severely compromised immunity (CD4˂200 cells/mcl), and 21.8% had extremely low levels (˂50 cells/mcl). Favorable virological response was observed in patients with good adherence, in whom 87,13% achieved undetectable viremia and a progressive increase in CD4 levels (100-150 cells/mcl/year) (46,5%, 95%CI(33,97-56,97), p<0,0001). In contrast, low- adherence patients showed high persistent viremia and a slow immunological evolution, associated with opportunistic infections (cerebral toxoplasmosis, pneumocystis jiroveci pneumonia, TB, esophageal candidiasis). The second-line ART has been shown to be effective in suppressing viral replication and improving immunological status, provided effective adherence. Constant monitoring and adaptation of therapeutic regimens are essential to prevent the development of ART resistance and improve prognosis in HIV/AIDS patients.

A contemporary approach to the surgical management of erysipelas complications

2026-02-10T10:17:52+02:00

The study enrolled 443 patients diagnosed with erysipelas between 2006 and 2025. The sample included 181 male participants and 262 female participants, with ages ranging from 21 to 89 years. The majority of the patient was over 50 years old, 372 (83.97%) subjects. The erythematous form was identified in 32 patients (7.22%), erythematous-bullous in 30 (6.77%), erythematous-hemorrhagic in 20 (4.53%), bullous hemorrhagic in 67 (15.12%), and destructive complications of erysipelas in 294 (66.36%). The occurrence of minor complications was recorded in 42.21% (187) of the cases, while major complications were noted in 24.15% (107). In 411 (92.78%) cases, erysipelas was localized on the lower leg. The surgical intervention for erysipelas is contingent upon the form and complications of the condition. New techniques for improving treatment include decompressive incisions of the dermis, the first use of negative pressure (VAC-vacuum assisted closure), and the Ilizarov apparatus to protect skin grafts on wounds located on the posterior and circular surfaces of the calf. The utilization of VAC aspiration resulted in a 50% reduction in treatment duration The use of VAC aspiration reduced the duration of treatment by one-half. Bicillin 5 was prescribed as a prophylactic treatment after discharge, administered once every 3 weeks for a minimum of 6 months, and indicated for recurrent forms up to 1-1.5 years. The surgical management of patients with erysipelas is supported by our own photographic images.

Secondary posttraumatic peritonitis

2026-02-10T21:32:33+02:00

Purpose. Analysis of the results of treatment of patients with injuries of abdominal organs complicated by secondaryperitonitisIntroduction. Posttraumatic peritonitis is one of the most dangerous complications of abdominal injuries, characterized by difficulties in early diagnosis, treatment and high mortality. Material and methods. We present an analysis of 38 patients with post-traumatic peritonitis treated at the Institute of Emergency Medicine in the period 2020-2024. Clinical examination of patients was performed taking into account hemodynamic stability. All victims received medical care and underwent a complex medical examination. Results. The analysis of the etiology of the lesions, skeletal damage, intra-abdominal organs and the causes of the development of extensive peritonitis is presented. The data of surgical and traumatological operations and the results of treatment are presented. Conclusions. Posttraumatic peritonitis is one of the main causes of mortality in abdominal trauma. Accurate diagnosis, urgent laparotomy, relief of extensive peritonitis and drug treatment significantly increase patient survival.

Management features of polytrauma patients with predominant musculoskeletal injuries

2026-02-11T10:05:13+02:00

Introduction. The shift in trauma patterns has brought the issue of polytrauma to the forefront among the epidemics of the 21st century. Despite modern methods of diagnosis and treatment, the management of patients with polytrauma remains a current and debated issue due to high mortality and loss of functional capacity in patients. Aim. To analyze the surgical treatment methods used in polytrauma patients, depending on the severity of the injury and the dominant lesions of the musculoskeletal system. Material and methods. The study included 64 polytrauma patients with predominant injuries of the musculoskeletal system: 50 men (78.13%) and 14 women (21.87%). The majority of patients were active individuals under the age of 50 (87.5%). Musculoskeletal injuries were associated by thoracic trauma in 43 patients and abdominal organ injuries in 5 cases (7.8%). All patients underwent full examination in accordance with the protocol adopted in the clinic. Results. In cases of pelvic and limb bone injuries, acute-phase interventions were limited to stabilization of fractures using external fixation devices. Minimally invasive surgical techniques were used in 61 cases (95.3%), providing early rehabilitation, reduced hospitalization time, and a lower rate of severe complications. Conclusions. Timely and qualified application of modern standard measures in providing medical care to patients with polytrauma, along with a multidisciplinary approach, ensures positive outcomes.

Medicolegal aspects of thoracoabdominal blunt trauma

2026-02-12T09:48:23+02:00

A total of 517 cases collected from the records of the Thanatology Department Chișinău were analyzed for the period 2020-2024. The study aimed to establish the frequency, structure, and predisposing factors of lethal thoracoabdominal traumas based on age, sex, circumstances of death and injury characteristics.The study found a predominant impact on males (70.41%), and the 60-69 age group emerged as the most susceptible demographic (21.7%). In 83% of cases, thoracoabdominal trauma was associated with injuries to other body regions. The most common injuries were rib fractures and pulmonary injures in the thorax and splenic rupture in the abdomen. The main cause of death in thoracoabdominal blunt trauma was hemorrhagic shock (50.7%).

Legal and medical aspects regarding data protection in the biobank USMF „Nicolae Testemițanu”

2026-02-13T20:59:42+02:00

The paper presents an analysis of the regulatory and technological framework applicable to the protection of personal data in the USMF “Nicolae Testemițanu” biobank. The purpose of the research was to assess the compliance of the digital infrastructure with national and European legislation on data protection, as well as the integration of international standards ISO/IEC 27001 and ISO 20387:2018. The methodology included the analysis of the applicable regulatory framework (Law no. 133/2011, GDPR, the National Law on Biobanks), a case study on the implementation of a Secure Information Registry, and a comparison with best practices promoted by ISBER, BBMRI-ERIC, and the OECD. The results demonstrated the application of advanced data encryption measures, authentication, and strict access control, as well as the use of standardized and withdrawal-enabled informed consent. The implementation of digital solutions contributed to enhancing data security and strengthening the biobank infrastructure as an institutional model of best practices. The main conclusion highlights the maturation of data governance in biomedical research in the Republic of Moldova and the importance of integrating international standards to promote responsible research and the effectiveprotection of individuals’ rights.

Intergative analysis of organizational culture and climate in public hospitals in the Republic of Moldova

2026-02-14T23:04:46+02:00

This study examines key aspects of organizational culture and climate in public hospitals in the Republic of Moldova, based on the perceptions of employees and patients. Employing a mixed-methods approach-both quantitative and qualitative-the research was conducted on samples of 825 employees, 845 patients, and 150 managers across eight public hospitals at the republican, district, and municipal levels. The study identifies and analyzes elements of organizational culture, culture types, and the perceptions of both employees and patients regarding the psychological climate. It explores fundamental components of organizational culture, such as beliefs, values, and norms, and their interrelation with organizational climate. Data were collected using questionnaires, psychodiagnostic tools, observation, interviews, and focus groups. The findings reveal a clear interdependence between organizational culture and climate, highlighting how institutional values, behavioral norms, and shared beliefs shape the workplace climate and how climate contributes to the development and strengthening of hospital cultures.

Saphenous veins - variants of drainage, saphenofemoral and saphenopopliteal junctions

2026-02-16T10:54:25+02:00

The study sought to identify the prevalence of anatomical variants of the two junctions - saphenofemoral and saphenopopliteal. The drainage of 22 great saphenous veins and of 24 small saphenous veins was evaluated by anatomical dissection. Duplication of the saphenofemoral junction (SFJ) with a bifid junction was observed in 13.6% of cases, and H-shaped SFJ - in 9.07% of cases. The number of tributaries of the SFJ ranged from 2 to 6, and most often their number was 3-4 (in 62.5% of cases). The small saphenous vein in 45.5% drained into the popliteal vein, forming the saphenopopliteal junction (SPJ). In the other 50% of cases, the small saphenous vein (its cranial extension) ascended on the thigh without having connections with the popliteal vein, and finally, in 4.2% the small saphenous drained into the medial gastrocnemius veins.

Variational specific features of the brachial artery

2026-02-19T09:35:20+02:00

Studying of the variational aspects of arteries is imposed by the modern requirements of the practical medicine. The purpose of the study was to evaluate the general and individual specific features of variability of the arteries of the arm. A retrospective, descriptive study was conducted on 70 embalmed upper limbs of both genders. Through anatomical dissection the anatomical and topographic features of the arteries of the arm were studied. Their variability constituted 28.6%: 18.6% in males and 10.0% in females; in 11.4% were established bilateral variants and in 8.6% - unilateral ones. Variants of origin were found out in 12.9%, numerical ones - 11.4%; common trunks - 5.7%; variants of the brachial artery branching patterns - 11.4%. This data will provide vascular surgeons with additional information to avoid possible errors during surgery.

Immunohistochemical exploration of differentiation and angiogenesis marker expression in umbilical cord structures

2026-02-21T12:07:29+02:00

Far from being a mere supportive tissue, Wharton’s jelly functions as a living mesenchymal niche, containing cells with stem-like properties, molecular signals for differentiation, and hints of a tissue dialogue that remains incompletely understood. The aim of this study was to perform an immunohistochemical characterization of CD105, CD34, VEGFR-2, and AC133 marker expression in Wharton’s jelly, in order to highlight the phenotypic diversity and biological potential of its cellular component. The study was conducted on 26 human umbilical cords. The samples were fixed in 10% buffered formalin, then processed using standard histological techniques and embedded in paraffin. Sections were stained with hematoxylin-eosin and immunohistochemically for the markers CD105, CD34, VEGFR-2, and AC133. Marker expression was evaluated semi-quantitatively in three regions of Wharton’s jelly, and the data were analyzed morphologically and statistically. CD105 showed strong expression, particularly in the peripheral zone of Wharton’s jelly, indicating the presence of a mesenchymal population with differentiation potential. CD34 and AC133 highlighted progenitor cell subpopulations with focal distribution and low to moderate intensity. VEGFR-2 was expressed in both endothelial and stromal cells, as well as in the extracellular matrix. A partial overlap of expression zones was observed for the studied markers, without complete cellular co-expression. The study revealed the active, heterogeneous, and functional nature of Wharton’s jelly, suggesting the existence of a complex cellular microenvironment capable of supporting processes such as cellular differentiation and angiogenesis.

The silent architecture of the prostate: histological perspectives on the neural landscape

2026-02-21T13:54:10+02:00

The neural network of the prostate plays a key role in regulating glandular and stromal functions, and the interactions between nerve fibers and tumor cells may influence prostate cancer progression. This study included 92 histological specimens, of which 80 were cases of prostate cancer and 12 were controls. The material was processed using conventional techniques and analyzed morphologically and immunohistochemically, with the use of S100 antibody for identifying neural structures. In normal prostate tissue, the neural network was well organized, with fine nerve fibers distributed periacinally and perivascularly, while larger structures were located in the periprostatic soft tissues. In malignant cases, perineural invasion was present in 33.7% of specimens, with increased incidence in poorly differentiated tumors and non - acinar carcinomas. It was frequently associated with desmoplastic stromal changes and the presence of intravascular tumor emboli. These findings support the hypothesis of an active interaction between neural structures and the prostatic tumor microenvironment, and suggest that perineural invasion may represent a relevant morphological marker for assessing tumor aggressiveness.

ADVERSE REACTION MANAGEMENT FROM THE VIEW OF PHARMACISTS AND THE ELDERLY

2026-02-23T10:29:58+02:00

The study investigates the level of awareness and attitudes of pharmacists and elderly people towards adverse reactions, drug precautions, knowledge of their reporting methods, drug compatibility and polypharmacy . By questioning respondents from both groups and applying statistical analysis, relevant differences were highlighted between the perception of pharmaceutical specialists and the real behavior of elderly patients. The results highlight a generally low concern on the part of patients towards the risks associated with drugs, as well as a limited knowledge of the methods of reporting adverse reactions. The discrepancies found between urban and rural areas indicate the need for specialized educational interventions, especially in rural areas, by pharmacists and the development of continuing pharmaceutical education programs is proposed to properly guide the elderly population.

Carotenoid and chlorophyll pigments in species of the genus Helichrysum.

2026-02-27T10:04:11+02:00

The carotenoid and chlorophyll pigments in plant tissues are valuable because they help protect the photosynthetic apparatus. Spectrophotometric chemical analysis of extracts from species of the genus Helichrysum ( H. arenarium andH. italicum) shows the highest carotenoid levels in the flowers, followed by the aerial parts, leaves and stems: H. arenarii flores - 10.74 mg /% and H. italici flores - 4.41 mg /% in 96% ethanol. Regarding chlorophyll pigments, a higher content of chlorophyll b was determined in leaves (H. arenarium - 10.7 mg /ml and H. italicum - 4.41 mg /ml in 96% ethanol). At the same time, the acetone extraction method revealed a higher chlorophyll a content in the leaves of both species (H. arenarii folia -98,92 mg/ml and H. italici folia - 51,61 mg/ml). These results indicate that both the choice of solvent and the nature of the plant material strongly influence the carotenoid and chlorophyll content.

Efficacy and safety of antiretroviral treatment in preventing vertical transmission of HIV in pregnant women

2026-03-02T22:58:07+02:00

Introduction: Mother-to-child transmission of human immunodeficiency virus (HIV) remains a significant cause of infant morbidity, particularly in regions with limited healthcare resources. Although modern antiretroviral therapies (ART) have substantially reduced this risk, challenges persist regarding early initiation of treatment, maternal adherence, pregnancy monitoring, and unequal access to prenatal care. Objective: The aim of this article is to analyze and synthesize recent scientific data on the prevention of vertical HIV transmission during pregnancy, by identifying effective therapeutic and prophylactic strategies and evaluating their level of application in current medical practice. Methods: This article is a review of the scientific literature addressing the prevention of vertical HIV transmission during pregnancy. Data were collected from internationally recognized databases, including PubMed, SCOPUS, and the Cochrane Library, using keywords such as “HIV vertical transmission,” “pregnancy,” “antiretroviral therapy,” and “neonatal prophylaxis.” Articles published between 2018 and 2025 in English or Romanian were included, provided they discussed prevention strategies, ART effectiveness, mode of delivery, breastfeeding, and postnatal interventions. Results: The rate of vertical HIV transmission can be reduced to below 2% when ART is initiated early, viral load is consistently monitored, and obstetrical management is adapted-such as through elective cesarean delivery whereindicated. In the Republic of Moldova, ART coverage exceeds 90%, and the incidence of vertical transmission has decreased significantly due to widespread prenatal screening and specialized counseling.Conclusions: Preventing mother-to-child HIV transmission requires an integrated, multidisciplinary approach based on early diagnosis, personalized treatment, and public health policies adapted to specific epidemiological contexts. Strengthening medical education and community support networks is essential for eliminating vertical HIV transmission.

REVIEW ON IMMUNOPATHOPHYSIOLOGY AND INFLAMMATORY BIOMARKERS IN SEVERE COVID-19. FROM MECHANISMS TO CLINICAL APPLICATIONS

2026-03-05T10:24:01+02:00

Introduction. Severe COVID-19 cases are characterized by a complex interaction involving viral-induced cellular damage, immune system imbalances, endothelial impairment, and inflammation-driven blood clotting. This article provides a comprehensive overview of the key pathophysiological mechanisms, it underscores the critical importance of inflammatory biomarkers in the diagnostic process, prognostic stratification, and therapeutic guidance. Understanding the relationship between these mechanisms and specific biomarkers facilitates a more personalized approach to managing critically ill patients with COVID-19. Aim og the article. The aim of this article is to provide a comprehensive and up-to-date review of the immune- related pathophysiological mechanisms underlying severe forms of COVID-19, with a particular focus on the diagnostic, prognostic, and therapeutic relevance of inflammatory biomarkers. By integrating recent clinical and molecular evidence, the paper seeks to highlight how these biomarkers can support early risk stratification and guide personalized therapeutic strategies, ultimately contributing to improved outcomes in critically ill patients. Material and Methods. The review was carried out through a systematic and extensive search of the specialized literature published between January 2020 and May 2025, using relevant databases (PubMed, Scopus, Web of Science, Google Scholar). Search terms such as: “severe COVID-19”, “inflammatory biomarkers”, “cytokine storm”, “immune dysregulation”, “CRP”, “IL-6”, “TNF-α”, “ferritin”, “D-dimer”, “RAAS”, “ARDS”, “NETs”, “endothelial dysfunction” were included. The included studies were selected based on the criteria of quality, thematic relevance, methodological validity and clinical applicability. Non-scientific articles, pediatric cases, commentaries and papers published in languages other than English were excluded. The selected articles were grouped by major themes: pathogenesis, biomarker classification, clinical utility and prognostic value.Results. The results of the analysis highlight that the severity of COVID-19 is determined by a complex interaction between endothelial dysfunction, excessive immune activation, RAAS imbalance and hypercoagulability. These mechanisms lead to systemic inflammation, immunothrombosis and multisystemic damage, especially pulmonary, renal, cardiac and neurological. The identified biomarkers - such as IL-6, CRP, D-dimer, TNF-α, ferritin and CXCL10 - reflect these processes and allow a dynamic assessment of the severity of the disease. Clinical studies have demonstrated that increased levels of these markers correlate with high mortality and variable therapeutic response. The use of biomarkers in guiding immunotherapy has shown significant benefits in prognosis and individualization of treatment.

Indications and Limitations of Genetic Testing in Common Adult Diseases

2026-03-05T11:13:36+02:00

Genetic testing for common adult diseases, such as chronic multifactorial conditions like type 2 diabetes, cardiovascular diseases, cancer, neurodegenerative disorders, and autoimmune diseases, enables individual risk assessment, early identification of predisposed individuals, and optimization of prevention or treatment strategies.Aim : To synthesize data on available genetic tests for major categories of common adult diseases, with relevant examples, indications, and limits. Materials and methods : We analyzed scientific literature published between 2015 and 2025, including narrative reviews, systematic reviews, observational studies, and clinical guidelines. Results: Genetic testing for common adult diseases primarily relies on polygenic risk scores (PRS), SNP genotyping, or targeted panels. Genetic testing is conducted within specialized genetic consultations and is recommended in specific clinical contexts: early disease onset (e.g., cancer before age 50), positive family history across multiple generations, atypical clinical presentations, therapeutic indications (e.g., pharmacogenomics), and reproductive counseling. In each case, genetic testing has specific indications and limitations. Limitations arise from incomplete gene penetrance, meaning not all individuals with a pathogenic variant develop the disease; no single genetic mutation fully determines risk; and variability in gene expression, where individuals with the same mutation may exhibit different clinical forms. Epigenetic and environmental factors also influence risk. Conclusions:Common adult diseases result from complex interactions between genes, epigenetics, and the environment.Genetic tests offer opportunities for prevention, diagnosis, and personalized treatment, with clinical utility varying by disease.The limitations of genetic testing stem from the etiological complexity of multifactorial diseases, requiring genetic counseling for result interpretation and communication.

CRISPR technology - innovative diagnostics for multidrug-resistant tuberculosis

2026-03-05T12:41:12+02:00

Multidrug-resistant tuberculosis (MDR-TB) remains a major public health challenge, with approximately 400,000 cases reported globally in 2023. The Republic of Moldova is among the countries with the highest incidence of MDR- TB in the European region. In this context, the application of a faster diagnostic method, with higher sensitivity and specificity compared to existing tuberculosis diagnostic techniques-such as bacteriological or molecular methods like GeneXpert-which could enable the detection of Mycobacterium tuberculosis (MTB) even in modest samples or in the absence of sputum, becomes increasingly urgent.This paper synthesizes recent data from the scientific literature regarding the use of CRISPR-Cas in tuberculosis (TB) diagnostics, with a focus on diagnostic accuracy, amplification methods, and its potential applicability in resource-limited settings.The CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) technology offers a new, precise, and efficient approach to the rapid diagnosis of MDR-TB, which is crucial for early diagnosis and timely initiation of appropriate treatment-key steps in preventing the global spread of multidrug-resistant tuberculosis.This article explores the CRISPR diagnostic mechanism, its advantages, and a comparative analysis with currently used tuberculosis (TB) diagnostic methods.

Controversies and certainties in the histopathological and immunohistochemical evaluation of infantile hemangiomas

2026-03-06T11:46:57+02:00

Infantile hemangiomas are the most common benign vascular tumors of childhood, with a high incidence in the neonatal period, especially in preterm infants. Although typically self-limiting, their etiopathogenesis remains incompletely understood, involving genetic, epigenetic, and perinatal factors (e.g., hypoxia, prematurity). A placental origin of the endothelial tumor cells is supported by immunophenotypic similarities to placental vessels and consistent GLUT-1 expression.The immunohistochemical profile varies depending on the evolutionary phase: the proliferative phase shows predominant expression of VEGF, PCNA, CD31, and CD34; the involutive and involuted phases are marked by regressive changes, including apoptosis, hyalinization, and adipocytic transformation. These differential markers are useful in distinguishing infantile hemangiomas from other benign or malignant vascular entities.Detailed histopathological examination and identification of key immunohistochemical markers remain essential for accurate diagnosis, classification, and treatment planning in infantile hemangiomas.

Proton pump inhibitors and the risk of Clostridioides difficile infection

2026-03-11T09:42:37+02:00

Clostridioides difficile infection has been highlighted as a major public health problem, including as one of the most common healthcare-associated infections. The use of drugs (antimicrobials, gastric antisecretory drugs) has been mentioned as a risk factor for the development of Clostridioides difficile infection. Proton pump inhibitors have been reported to be frequently prescribed not only for the treatment of conditions associated with gastric hypersecretion, but also in a number of less specific conditions. Considered safe and effective drugs, their frequent and, especially, long- term use motivated researchers to study the harmlessness of proton pump inhibitors. In this context, their influence on the absorption of vitamins and minerals, the development of infections (intestinal, pulmonary), renal and cardiovascular diseases, gastric cancer, dementia, etc. has been investigated. The development of Clostridioides difficile infection, induced by proton pump inhibitors, has been considered an adverse reaction with an increasing incidence, and the elucidation of the pathogenesis and responsible mechanisms is essential for the management of the rational use of these antisecretory drugs.

Comorbidities Associated with Heart Failure: Clinical and Therapeutic Implications

2026-03-13T09:30:25+02:00

Heart failure remains a leading cause of hospitalization and mortality in developed countries. Ongoing demographic shifts, especially population aging, are expected to increase its prevalence. The frequent coexistence of comorbidities further worsens the prognosis and survival outcomes. Among patients with heart failure with preserved ejection fraction, the most common comorbidities negatively influencing prognosis are arterial hypertension, atrial fibrillation, type 2 diabetes mellitus, chronic kidney disease, and coronary artery disease. Current therapeutic strategies are primarily aimed at symptom relief and the management of associated conditions. At present, the most effective approach is prevention, focusing on early recognition and reduction of risk factors.

Prevalence of arrhythmias in patients with diabetes mellitus - evidence from current literature

2026-03-16T12:11:18+02:00

Introduction: Diabetes mellitus is a chronic metabolic disorder with an increasing global prevalence, associated with a substantial burden of cardiovascular complications. Arrhythmias, particularly atrial fibrillation, are common manifestations in patients with diabetes, contributing to increased mortality and morbidity risk. Objective: To assess the prevalence and types of arrhythmias in patients with diabetes mellitus (DM) based on recent scientific literature. Methods: Narrative review of studies published between 2015-2025 (PubMed, Google Scholar, Hinari), including meta-analyses, population-based cohorts, and observational studies reporting arrhythmia prevalence in DM. Results: Atrial fibrillation is the most prevalent arrhythmia, with reported rates between 9-25% and a relative risk increase of 17-28% compared to the general population. Conduction disorders, bundle branch blocks, and prolonged QTc (≈13% of DM patients) are frequently observed and associated with an increased risk of malignant ventricular arrhythmias. Extended ECG monitoring reveals undiagnosed asymptomatic (“silent AF”) cases. Conclusions: DM is associated with a significantly increased prevalence of arrhythmias, supporting active screening, periodic cardiac monitoring, and QTc. These data support active screening through extended ECG monitoring and periodic repolarization assessment in DM patients.

THE IMPORTANCE OF GUT MICROBIOTA IN PERSONALIZED APPROACH FOR OBESITY

2026-03-17T11:27:41+02:00

Introduction. The impact of intestinal microflora on various processes, including metabolic, immune, and inflammatory processes, has been proven. Considering an individual’s intestinal microbiome profile could influence the personalized approach to obesity management. Materials and methods. A conducted literature review used the PubMed and Google Scholar search engines to select full versions of articles in English from 2019 to 2025. Results. Numerous studies confirm the importance of maintaining the variability of the gut microbiome in obesity management. Particular attention is given to personalized nutrition for managing or preventing the disease. Intestinal dysbiosis develops as a result of a diet low in fiber and high in fat and animal protein; a sedentary lifestyle; exposure to toxic substances (pesticides), etc. Dysbiosis induces epigenetic changes, such as DNA methylation, non-coding RNA, and chromatin remodeling having negative effects on the epigenome and causing disturbances in carbohydrate and lipid metabolism. Individual restoration of intestinal balance is possible through molecular-genetic methods with the identification of intestinal microflora diversity and the subsequent implementation of personalized interventions. Conclusion. The personalized approach to people with obesity is aimed at increasing the diversity of the intestinal microbiome through various methods. These interventions are based on personalized nutrition and on interventions such as activity regimens, administration of prebiotics, probiotics, postbiotics, or symbiotics, and fecal microbiota or bacteriophage transplantation, in addition to many other surgical, therapeutic, and behavioral interventions for the personalized treatment of obesity.

LIVER ABLATION IN CIRRHOTIC PATIENTS WITH CLINICALLY SIGNIFICANT PORTAL HYPERTENSION: CURRENT EVIDENCE, CHALLENGES, AND EMERGING ROLE OF ELASTOGRAPHY

2026-03-18T12:00:25+02:00

Liver ablation is a cornerstone therapy for early-stage hepatocellular carcinoma (HCC), offering a curative-intent option for patients ineligible for resection or transplantation. However, the presence of clinically significant portal hypertension (CSPH) raises safety concerns due to the increased risk of bleeding, liver decompensation, and technical difficulties. This review aims to critically analyze the safety and efficacy of liver ablation in patients with CSPH, examine conventional and novel risk stratification tools, and highlight the emerging role of liver and spleen elastography in pre-procedural assessment. Integrating elastography assessment with standard clinical indicators may improve patient selection and procedural planning in cirrhotic patients with portal hypertension (PH) undergoing liver ablation. Further prospective validation and risk stratification models are warranted.

Ulcerative colitis in children: contemporary views of diagnostic and therapeutic management

2026-03-19T09:57:09+02:00

Ulcerative colitis (UC) in children is a chronic inflammatory disease of the colon that belongs to the group of inflammatory bowel diseases (IBD) with a increasing global incidence rate. Effective diagnosis and treatment of pediatric UC require adherence to and application of a comprehensive multidisciplinary approach. Treatment of UC in children is aimed at achieving clinical and laboratory remission, reducing the activity of the inflammatory process with drug therapy, the phased use of modern biological agents and in the event of complications, surgical intervention. This article analyzes modern practical approaches to solving these problems and analyzes modern strategies for treating emergency conditions in children in the context of updated international guidelines.

Vestibular disorders in multiple sclerosis: clinical and management aspects (narrative review)

2026-03-20T10:04:53+02:00

Vestibular disorders are a frequent and disabling manifestation in multiple sclerosis (MS), with complex pathophysiological mechanisms involving both central structures and associations with peripheral vestibulopathies, such as benign paroxysmal positional vertigo (BPPV).Objective of the study. To perform a detailed evaluation of the specialized literature in order to analyze the relationships between the clinical forms of MS, lesion topography, types of vestibular syndromes, functional markers, and treatment options. Materials and Methods. Literature synthesis, conducted in accordance with PRISMA, of 39 articles published between 2015-2025 in English in PubMed, Elsevier, Frontiers, and ResearchGate. Results. Relapsing-remitting MS (RRMS) is more frequently associated with acute/episodic vestibular syndromes related to new lesions in the brainstem/vestibulo-cerebellar region, while progressive forms present with chronic vestibular syndrome. vHIT, VEMP, VNG, and posturography correlate with MS severity and progression. Effective interventions include personalized vestibular rehabilitation, repositioning maneuvers for peripheral forms, and early treatment of relapses. Recent studies support the benefits of VR-based therapy and integrated rehabilitation programs in improving balance and reducing dizziness. Conclusions. An integrated approach, guided by phenotype and objective markers, optimizes the differential diagnosis of vestibular disorders in multiple sclerosis and the personalization of therapy/rehabilitation, with potential to reduce dizziness, improve balance, and lower the risk of falls.

Venous thromboembolism in pregnancy: therapeutic options

2026-03-24T10:26:21+02:00

Introduction. Venous thromboembolism is a rare but significant cause of maternal morbidity and mortality during pregnancy and postpartum, affecting 1 in 1,000-2,000 pregnancies. Despite advancements in the treatment of venous thromboembolism in the general population, its management during pregnancy remains a challenge due to therapeutic limitations and the risks associated with anticoagulants for both the mother and the fetus. Prevention and treatment predominantly rely on the use of unfractionated heparin or low-molecular-weight heparin, which, while effective, are associated with maternal and fetal risks such as thrombocytopenia, osteoporosis, and neonatal bleeding. Methods. The study included original articles from specialized journals such as PubMed, Cochrane Library, and Google Scholar, focusing on venous thromboembolism, deep vein thrombosis, and pulmonary embolism during pregnancy. Articles on superficial venous thrombosis, arterial thrombosis, and other uncommon locations were excluded. The search strategy used controlled terms and relevant keywords. Results. Venous thromboembolism is the leading cause of maternal mortality in developed countries, with a postpartum risk of pulmonary embolism up to 35 times higher than during the antepartum period. Pregnancy-specific hypercoagulability is influenced by physiological factors such as increased levels of fibrinogen and coagulation factors. Hemostatic changes, mechanical compression of pelvic veins, and venous stasis contribute to the predisposition for venous thromboembolism. Anticoagulant treatments such as low-molecular-weight heparin and unfractionated heparin are most commonly used, involving distinct therapeutic phases: initial, primary, and extended, each with specific objectives in preventing venous thromboembolism recurrence. Conclusions. Managing venous thromboembolism during pregnancy requires personalized approaches that balance the risks and benefits of anticoagulation. Improving treatment strategies depends on further research to evaluate the safety and efficacy of new anticoagulants, particularly during pregnancy and postpartum.

The role of ultrasound in medico-legal assessment of blunt knee trauma

2026-03-24T12:08:00+02:00

This article explores the role of musculoskeletal ultrasound in the medico-legal evaluation of blunt knee trauma, emphasizing its practical advantages within forensic practice. Drawing on recent scientific literature, the study outlines the diagnostic potential of ultrasound in detecting ligament, tendon, meniscal, and bursal injuries - types of damage that often go unnoticed through conventional imaging. Ultrasound proves to be a non-invasive, accessible, and dynamic method, particularly valuable in cases where advanced imaging is either unavailable or contraindicated. The findings underline the relevance of ultrasound as a supportive diagnostic tool in the objective forensic assessment of blunt injuries to the knee joint.

Current trends and challenges in the surgery of chronic pancreatitis and its complications - 35 years of experience at the department of surgery no.2

2026-03-25T13:16:36+02:00

The research presents the results of surgical treatment applied to 653 patients with chronic pancreatitis (CP) and its complications, during the period 1990-2025, at the “Timofei Moșneaga” Republican Clinical Hospital, Hepatopancreatobiliary Surgery Department. The study focuses on a comprehensive analysis of surgical treatment methods, including endoscopic, laparoscopic, and open (laparotomic) approaches. The surgical interventions performed were diverse, with specific indications tailored to each individual patient. The study outlines the outcomes of various surgical techniques, highlighting their advantages, disadvantages, and postoperative complications.

From academic initiative to systemic influence in health: the history of a department with reforming visions

2026-03-25T22:47:32+02:00

The article analyses the reforming impact of the Department of Economics, Management and Psychopedagogy within the “Nicolae Testemițanu” State Medical University, founded in 1997 by Professor Constantin Ețco. By integrating transdisciplinary sciences - economics, management and psychopedagogy - into medical training, the department has developed an applicative educational model, oriented towards training leaders, managers and reform pedagogues, as well as doctors with economic, managerial and leadership knowledge and skills. This experience, with lasting effects on health policies and the training of human resources in the field, is today part of the history of modern medical training in the Republic of Moldova.

Clinical characteristics and long-term management of hospitalized patients with acute heart failure: results of the ESC Heart Failure Long-Term Registry Republic of Moldova

2026-03-26T09:56:42+02:00

Purpose. description and analysis of the hospitalized patients with acute heart failure, who were included in the ESC Heart Failure Long-Term Registry Republic of Moldova (ESC-HF-LT Registry RM), their gender differences and the evolution of adherence to optimal drug treatment over the last ten years in the RM. Material and methods. The study group consisted of 254 patients older than 18 years, hospitalized with acute heart failure (HF) during the period 2011 - 2014 in 2 centers in the Republic of Moldova. Results. The majority of hospitalized patients were men (64.9%), with a higher mean age in women. The main cause of HF was ischemic heart disease. Arterial hypertension was more common in women: 80.9% vs 67.9% in men, p<0.05, but among men there were fewer smokers and alcohol drinkers. The main cause of admission was exacerbated heart failure, in patients included in the ESC-HF-LT registry. The mean LV EF values were higher in women: 44.1% vs 37.3% in men, p<0.01. Mortality and readmission rates at 12 months were similar in the female and male patient groups. Conclusion. The clinical characteristics and 12-month outcomes of patients hospitalized with heart failure in the Republic of Moldova were similar compared to patients from other countries included in the ESC Heart Failure Long- term Registry. The rate of drug prescription for the optimal treatment of heart failure in recent years has been high, especially for ACE inhibitors/ARBs and beta-blockers, with a positive trend in the prescription of SGLT-2 inhibitors.

Integration of conventional medicine with holistic medicine: personalized approach, integrative concept

2026-03-26T12:21:14+02:00

In recent decades, conventional medicine has made remarkable advances in the diagnosis and treatment of acute and chronic diseases. However, a significant number of patients continue to experience residual symptoms, poor quality of life, or adverse reactions to standardized therapies. In this context, there is a growing trend toward integrating classical medicine with scientifically validated complementary approaches, within a patient-centered model tailored to individual biotypes. This article explores the scientific rationale for such integration, outlines the principles of personalized intervention, and illustrates its applicability through a documented clinical case of an oncology patient undergoing adjuvant therapy. Comparative tables of biological parameters and quality-of-life assessments are included, alongside a critical discussion of the limits and prospects of integrative medicine.

Lie and its detection: assessing nonverbal behaviors in criminal investigation

2026-03-26T13:12:38+02:00

Lying is a common behavioral strategy used in criminal investigations, and its detection has become an essential component of criminal psychology. This article explores various methods for analyzing nonverbal behavior - facial microexpressions, gestural incongruences, physiological reactions, and the cognitive interview technique - as tools for lie detection [1, 2, 3, 4]. The paper highlights the practical usefulness of these methods in judicial investigations and emphasizes their limitations when not interpreted by trained professionals [1, 3].