Bulletin of the Academy of Sciences of Moldova. Medical Sciences

Review of the monograph: “Major Cognitive Disorders (Dementia) in Patients with Neurodegenerative and Vascular Pathology. Pathophysiology, Diagnosis, Treatment”

Vitalie LISNIC — Tue, 09 Sep 2025 00:00:00 +0300

The monograph “Major Cognitive Disorders (Dementia) in Patients with Neurodegenerative and Vascular Pathology” was prepared under the editorship of Professor Mihail Gavriliuc, Doctor of Medical Sciences, by the team of authors from the prestigious “Diomid Gherman” Institute of Neurology and Neurosurgery - Lilia Rotaru, Doctor of Medical Sciences, Associate Researcher; Ana Belenciuc - PhD student; Oxana Grosu, Doctor of Medical Sciences, Master in Public Health Management; Ghenadie Cărăușu, Doctor of Medical Sciences, University Professor. The topic addressed is extremely current and widely studied in the international scientific literature. Dementia is a term encompassing multiple underlying diagnoses and reflects a progressive cognitive impairment, significantly affecting an individual's functional abilities and impacting not only the affected person but also their family and caregivers, as well as society and the economy. Among all causes of dementia, the most widespread and representative is Alzheimer’s disease, but there are many other neurodegenerative dementias, as well as dementias secondary to structural or functional brain lesions. All of these conditions are thoroughly addressed in this work. The fact that people of working age are also affected means that these conditions influence the professional functional capacity of those affected, with corresponding financial and economic implications. Globally, over 55 million people are affected by dementia, according to WHO data, particularly in low- and middle-income countries. The incidence and prevalence of dementia are high, which entails enormous costs for diagnosis, treatment, and especially care. With increasing life expectancy worldwide, dementia care needs in specialized institutions are rising. The association of dementia with various age-related comorbidities further increases these care costs. The high prevalence of dementia and its financial implications have driven research in this field, resulting in a wealth of scientific data regarding underlying mechanisms, diagnostic methods, and treatment options. Accurate diagnosis forms the basis for appropriate therapeutic approaches, and this work is extremely valuable for familiarizing the medical community with fundamental scientific data, classifications underlying disease diagnosis, and management. Equally important are the data regarding approved and experimental therapies currently under development. An essential part of this monograph is devoted to non-pharmacological approaches. Recognition of dementia and underlying pathologies, as well as application of classifications with diagnostic criteria, allows for faster and more accurate diagnosis, enabling the patient to receive early treatment and be placed at the center of a multidisciplinary team of specialists providing personalized management. The monograph uses explicit language in describing pathophysiological, clinical aspects, and currently available management. The work plan follows the DSM-V classification of neurocognitive disorders but also presents classifications considered the most valid for each specific nosology, developed by relevant professional societies. Based on modern and up-to-date data, this work has real scientific value, presenting information from the latest literature with an exhaustive and current bibliography. Illustrative graphical representations - tables, boxes, figures - greatly facilitate understanding of the text. The work has significant practical importance by promoting increased knowledge of the issue and is intended for a wide audience of neurologists, internal medicine physicians, general practitioners, residents, and students. On the basis of the above, the monograph “Major Cognitive Disorders (Dementia) in Patients with Neurodegenerative and Vascular Pathology. Pathophysiology, Diagnosis, Treatment” is recommended for publication (23.06.2023).

REVIEW of the monograph “RELAPSE OF TUBERCULOSIS”

Ion HAIDARLI — Tue, 09 Sep 2025 00:00:00 +0300

The monograph “Relapse of Tuberculosis” is a scientific work distinguished by its relevance and major importance. The author addresses one of the most pressing issues faced by public health. Tuberculosis relapse is characterized by its impact on the epidemiological situation, which is already reflected in the first chapter of the work. The monograph is structured into 5 chapters, presenting the most significant aspects of tuberculosis relapse. Considering the subject, the work consistently highlights the risk factors for developing relapse. Understanding their complexity and implications will contribute to the development of appropriate actions and strategies to counter the negative impact of relapse on healthy individuals. This monograph is not only a source of knowledge but also an important guide, providing updated and relevant information for a deeper understanding of the role of immunological and genetic mechanisms in the development of tuberculosis relapse. In this regard, the work describes the responses of natural resistance and acquired immunity to Mycobacterium tuberculosis, including the immune particularities in relapse. The main genetic aspects detailed include the genetic basis for susceptibility to tuberculosis, genetic control of tuberculosis infection and disease, innate human immunogenetics, and mycobacterial susceptibility. Factors influencing the functions of innate immunity gene polymorphisms are elucidated. The author presents current progress in studying polymorphisms associated with susceptibility/resistance to tuberculosis, including studies conducted on the local population and at the genome level, which provide important evidence for the role of the genetic factor in tuberculosis development, with heterogeneous effects depending on population, clinical phenotypes, and epidemiological situation. This scientific-practical work provides relevant and up-to-date information, with coherently structured topics. It is an important contribution, fostering a deeper understanding of the complexity of tuberculosis relapse. The presence of extensive factual material, skillful use of national and international data, as well as critical and multi-perspective reflections on the issue are noted. The author demonstrates high competence by using a representative, extensive, and recent bibliography, proving a solid knowledge of the research subject. The text is clearly written, with rigorous and convincing presentation, reflecting the author’s professionalism and remarkable scientific preparation. The monograph is of special scientific and practical interest and can serve as a reference for specialists, academics, residents, and students. Thus, the subject is highly relevant, both theoretically and practically, and opens new directions for scientific research.

Comon causes of shoulder pain

Ruxanda MALARCIUC, Nina ISTRATI , Victoria SIMON — Tue, 09 Sep 2025 00:00:00 +0300

In this article, we analyzed the specialized literature regarding the common causes of shoulder pain. The characteristics of both conservative and surgical treatments are presented. Shoulder pain can be caused by various conditions, such as traumatic injuries, tendinitis, impingement syndrome, and osteoarthritis. These conditions are often diagnosed based on clinical symptoms, and treatments are tailored according to the underlying cause. Among the most common causes of shoulder pain are trauma, congenital anomalies, joint degeneration, and inflammation. Particular attention is given to diagnostic methods, including imaging investigations and specific physical tests.

Seronegative myasthenia gravis. Subtypes and clinical manifestations

Gabriela FRUMOSU, Nina ISTRATI — Tue, 09 Sep 2025 00:00:00 +0300

Approximately 10-15% of patients diagnosed with Myasthenia gravis do not have detectable antibodies in standard tests. This may be due to the presence of pathogenic antibodies against postsynaptic membrane antigens other than AChR, or the antibody levels may be below the detection limit. The discovery of low-affinity anti-AChR, anti-MuSk, ani-LRP4, anti-agrin, anti-cortactin antibodies represents a considerable advance in the understanding of the pathophysiology. In recent years, significant progress has been made in the development of antigen-specific therapies that specifically target immune cells or autoantibodies involved in the autoimmune response.

Scalene syndrome

Victoria NEZNAICO, Nina ISTRATI — Tue, 09 Sep 2025 00:00:00 +0300

In this article, we analyzed the specialized literature regarding the exclusivity of scalene syndrome manifestations. This syndrome is a part of Thoracic outlet syndrome (TOS) and is classified as vascular (arterial and venous) and/or neurogenic. The scalene syndrome, depending on the compressed structure in the interscalene triangle, is characterized by a different clinical picture: nerve - pain, muscle weakness, paresthesia, then limitation of movements, artery - reduction of blood flow in the vertebral artery, swelling, paleness of the hand. It is more common in women between the ages of 20 and50. Among the most common causes are: trauma, congenital anomalies, osteochondrosis and hypertrophy of the anterior scalene muscle. Particular attention is paid to diagnostic methods: physical tests (Roots, Adson, Wright) and instrumental tests (electromyography, electroneurography, specific signs on USG, CT, MRI). The characteristics of conservative and surgical treatment, which possess a favorable prognosis and pain - free life with full range of motion, are presented.

Neurological clinical presentation of long covid syndrome

Oxana GROSU, Cornelia TURCAN, Lilia ROTARU, Stela ODOBESCU, Ion MOLDOVANU — Tue, 09 Sep 2025 00:00:00 +0300

Patients who have suffered from COVID-19 after a certain time report a wide range of new or persistent symptoms (symptoms that persist for at least 12 weeks) called “long COVID-19 syndrome”.Aim: Narrative review regarding post-Covid-19 symptomatology to establish the clinical variability. Material and Methods: To achieve the purpose of the study, a systematic analysis of literature data on the given topic was performed. Thus, scientific sources were studied in the scientific citation databases PubMed, Google Scholar, Web of Science, eLibrary. Results and discussions: According to the studies analyzed, most patients most often manifest fatigue, cognitive disorders and sleep disorders, less often present other neurological disorders (headache, anxiety, depression, etc.). Patients with long COVID-19 syndrome report sleep disorders such as insomnia or drowsiness. These people have greater difficulty falling asleep at the desired time and also waking up at the desired time. In some patients, sleep disorders were present even after 12 months after Covid-19, with a negative impact on the quality of life of patients. Headache is one of the earliest and most common symptoms of long COVID-19 syndrome. The presence of headache in the acute phase of Covid-19 infection was considered a positive prognosis, being associated with lower severity and mortality. Headache may persist to a significant extent in the long term. Depression and anxiety may be more a result of the severity of the illness and psychological trauma following the pandemic than a result of the viral infection. Anxiety and depression have significant long-term consequences. Conclusions: Long COVID syndrome is a complex condition with prolonged heterogeneous symptoms. Our study suggests the presence of fatigue, cognitive impairment, sleep disorders, headache, anxiety, and depression in the neurological symptomatology of long Covid syndrome. The persistence of long-term symptomatology highlights the importance of a holistic and continuous approach to better understand the impact of this disease on health and establish appropriate management.

Neurological services in the post-pandemic period

Tue, 09 Sep 2025 00:00:00 +0300

The Covid-19 pandemic has become an enormous challenge for the entire medical system. After the global vaccination campaign, humanity is returning to normal life, but the impact and changes it has produced are still palpable.The aim of the research is to analyse how neurological practice has changed after the end of the Covid-19 pandemic. Materials and methods. The literature review was conducted in accordance with the PRISMA criteria. The databases used to search for articles were Google Scholar and PubMed, for this purpose the following keywords were used: “tele neurology”, “pandemic”, “research”, “Tele Education”, “technology”. Articles published between 2020 and 2024, inEuropean languages, were considered eligible. After evaluating the abstracts and titles, 44 articles were selected.Discussions. The pandemic created premises for the rapid implementation of Teleneurology, Tele Education and the digitalization of neurological services, facilitating the population’s access to them. Virtual platforms for consultations, communication, courses and conferences were identified or created. Technologization and digitalization have gained a new dimension, overcoming the barriers artificially imposed before the pandemic, demonstrating their usefulness including through clinical studies. The restrictions have forced neurologists to become more flexible and creative. Conclusions: Paradoxically, despite the restrictions imposed by the pandemic, neurological services and continuing medical education have now become more accessible through the widespread implementation of digital technologies. However, their introduction as routine practice requires careful assessment of the risks and benefits.

Periventricular leukomalacia - the clinical-imaging challenge. A narrative review

Catalina DONCA, Zinaida BÎLHAC , Tatiana PLESHCAN, Marina SANGHELI — Tue, 09 Sep 2025 00:00:00 +0300

Periventricular leukomalacia (PLM) is a term used to describe white matter damage to the brain of premature infants, with both a focal and diffuse component. The aim of the study was to analyze bibliographic data with reference to the causes, risk factors, clinical presentation and imaging criteria for the differential diagnosis of periventricular leukomalacia with other pathologies. The methodology for selecting bibliographic sources included accessing the medical databases PubMed - Medline, Hinari, using the keywords: “periventricular leukomalacia”, “magnetic resonance imaging”, “multiple sclerosis”, “cerebral microangiopathy”, “differential diagnosis”, for the last 25 years. From about 2000 publications, 25 scientific sources in English relevant to the studied subject were selected.Results: The word “leucomalacia” is derived from the greek “leukos” meaning white and “malacia” meaning softening. Periventricular leucomalacia is morphologically defined by 2 histopathological components - a focal necrotic component in the periventricular region of the cerebral white matter and a diffuse component characterized by reactive gliosis in thesurrounding white matter. The “watershed” vascularization of the periventricular region determines increased sensitivity to hypoxic-ischemic events, with the subsequent development of periventricular lesions with ventricular wall deformation that can be diagnosed by transcranial ultrasonography in newborns or by magnetic resonance imaging (MRI) in patients of different ages. Periventricular lesions in T2w hypersignal are not characteristic only for periventricular leukomalacia, they are also evidenced in pathologies such as multiple sclerosis, cerebral microangiopathy, but can exist as a variant of the norm in the terminal myelination areas of the white matter. The challenges of the differential diagnosis of periventricular leukomalacia arise especially in cases when patients did not present clinical manifestations characteristic of the pathology in childhood, but being examined by cerebral MRI in adulthood for other reasons, imaging changes apparently similar to those in multiple sclerosis, cerebral lacunar infarcts, etc. are highlighted. When discrepancies appear between clinical and imaging manifestations, they should be treated with caution and require additional investigations.Conclusions: Knowledge of the typical radiological manifestations of PLM with changes in the periventricular region, associated with ventricular wall traction and local atrophy of the affected white matter, will allow avoiding the wrong diagnosis of this pathology. For a more accurate interpretation of the characteristic PLM lesions in the differential diagnosis with periventricular changes of other genesis, it is important to collaborate between the clinician and the imaging physician in order to provide data from the patient’s disease history, including data related to the antenatal and early postnatal period, for a correct therapeutic decision for the benefit of the patient.

Ocrelizumab in the treatment of multiple sclerosis: a literature review

Tue, 09 Sep 2025 00:00:00 +0300

Ocrelizumab, a humanized monoclonal antibody that targets CD20-positive B cells, has significantly advanced the treatment of multiple sclerosis (MS). Approved for both relapsing-remitting MS and primary progressive MS, it represents a novel approach in MS therapy. Since the end of 2023, Republic of Moldova has incorporated ocrelizumab into its national treatment guidelines, providing access to this innovative therapy for its population. This review provides a detailed analysis of ocrelizumab’s mechanism of action, clinical efficacy, safety profile, and long-term impact based on data from clinical trials and real-world studies. Additionally, the review explores ocrelizumab’s comparison with other disease-modifying therapies, its role in patient quality of life, and the future direction of MS treatment.

Functional movement disorders: a paradigm shift (literature review)

Madalina CEBUC, Lilia ROTARU, Marina SANGHELI, Oxana GROSU — Tue, 09 Sep 2025 00:00:00 +0300

Functional neurological disorders (FND) represent a group of pathologies in which the functioning of the nervous system is impaired. Recent advancements in research have led to a better understanding of the involved pathophysiological processes and the development of new strategies for early diagnosis. In particular, functional movement disorders (FMD) have benefited from updates to diagnostic criteria and management strategies.Aim of the Study: The aim of this research was to conduct a detailed review of the literature in order to analyze the clinical and diagnostic approach to FMD. Materials and Methods: The literature synthesis, carried out in accordance with PRISMA guidelines by two authors (OG, MC), included 47 articles published between 01/2020 and 06/2024 in English in PubMed-Medline and ResearchGate, supplemented with 7 relevant articles from citations/bibliographies. Results: FMD are pathophysiologically explained through a duality: defects in neurocircuitry involving self - agency, salience, and emotion processing systems, and psychosocial influences (predisposing, precipitating, and perpetuating factors). This paradigm shift has contributed to the development of new diagnostic tactics based on “rule - in” criteria, supported by pillars such as incongruence, inconsistency, variability, and distractibility. It has also improved communication strategies with patients to ensure compliance. Additionally, a holistic management approach based on physical rehabilitation, psychotherapy, and pharmacological treatment when necessary, initiated as early as possible, is key to ensuring effective treatment and quality of life. Conclusions: Functional movement disorders represent a significant challenge in neurology, but recent advances in understanding the pathophysiological mechanisms and the adoption of “rule - in” diagnostic criteria have led to more effective treatments and better clinical outcomes. It is crucial for neurologists to adopt these new approaches to improve patient care and transform medical practice.

Neurological complications post - COVID-19 vaccination

Tue, 09 Sep 2025 00:00:00 +0300

Following vaccination of the population against Covid-19 infection, a multitude of neurological complications have been reported, from the most frequently encountered to the rarest. In our article we present a narrative analysis of two databases: PubMed and Google Scholar for all types of published studies (case reports, case series, cross-sectional study with a meta-analytic literature review, systematic review, meta-analysis, retrospective study, cohort study). Headache is one of the most publicized, early onset complications, it can be migraine type - 51.1% and tension type - 27.4%, most frequently starting after the administration of the AstraZeneca vaccine, followed by the Sputnik V vaccine. The incidence of ischemic stroke was recorded from 0.29 to 1.76 million vaccinees, while hemorrhagic stroke represents364.7 per 1 million people, developing more frequently after mRNA vaccines. MOG encephalomyelitis was also recorded postvaccination, manifested by optic neuritis, with onset 10 days after the 1st dose administered, more susceptible being after the AstraZeneca vaccine. Acute disseminated encephalomyelitis (ADEM) was reported after the SinoVac and AstraZeneca vaccines, manifesting as sensory disturbances, seizures, and focal neurological deficits. GBS after COVID-19 vaccination occurs in 8.1 per 1,000,000 vaccinations, more frequently after mRNA vaccines. Optic neuritis occurs after inactivated vaccines, adenoviral vaccines, and messenger RNA vaccines, while multiple sclerosis begins after the administration of Pfizer and AstraZeneca vaccines. Transverse myelitis and Bell’s palsy are more common with the Moderna vaccine, while sinus thrombosis and TIA develop more often after the Johnson-Johnson vaccine.

Neurological complications post - COVID-19 infection

Tue, 09 Sep 2025 00:00:00 +0300

The Sars-CoV-2 virus is from the coronavirus group with an affinity for affecting several systems, such as respiratory, cardiovascular, renal, gastrointestinal. A special role belongs to the nervous system, this infection involving the central nervous system (CNS) and the peripheral nervous system (PNS). The main viral transmission routes are the peripheral, hematogenous and lymphatic routes. Angiotensin convertase 2 (ACE2) has an essential role in the pathogenesis of Covid-19, underlies the inflammatory mechanisms and the so-called “cytokine storms”, influencing the development of coagulopathies and subsequent complications, with viral invasion of brain tissue due to crossing the blood-brain barrier. In the article, we analysed the main routes of viral invasion, as well as the neurological complications developed,involving both the central and peripheral nervous systems.

Doctors’ Attitudes Toward Medical Errors: Support Measures for Doctors and Error Prevention

Tue, 09 Sep 2025 00:00:00 +0300

The article analyzes doctors’ attitudes toward medical errors and prevention measures. It focuses on the consequences of errors for professional activity and identifies support measures to reduce risks. A survey of 60 doctors revealed stress and guilt as the main consequences of errors. Opinions on the effectiveness of support systems were divided. The findings highlight the need for effective training strategies and a supportive environment for open discussions about errors.

THE THREE PILLARS OF LEGAL PROTECTION FOR DOCTORS IN THE ERA OF DIGITAL MEDICINE: PROTOCOLS, DOCUMENTATION, CONSENT

Constantin PISARENCO, Serghei PISARENCO — Tue, 09 Sep 2025 00:00:00 +0300

This article explores the primary legal aspects of physician protection in the context of digital medicine. It examines three key elements of legal defense for doctors - clinical protocols, medical documentation, and informed consent. Legal risks associated with the use of electronic systems are discussed, along with recommendations to minimize liability. The author also addresses issues of data privacy and the use of telemedicine technologies, emphasizing the need for legal regulation and security standards in the digital environment.

PLEURO-PULMONARY MANIFESTATIONS IN CONNECTIVE TISSUE DISORDERS IN SUDANESE PATIENTS: CROSS-SECTIONAL STUDY

Tue, 09 Sep 2025 00:00:00 +0300

Background: Connective Tissue Disorders (CTDs) frequently affect the respiratory system, with complications such as interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), and pleural effusions being major contributors to morbidity and mortality. This study investigates the prevalence and patterns of pulmonary manifestations in Sudanese patients with CTDs and evaluates diagnostic correlations using pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT). Material and Methods. A cross-sectional study was conducted involving 75 CTDs patients presenting with respiratory symptoms at hospitals in Khartoum, Sudan. Data collection included clinical evaluations, PFTs, HRCT scans, and laboratory investigations. Statistical analyses were performed to determine the prevalence of pulmonary complications and their correlations with CTDs subtypes. Results. ILD was the most common manifestation, with an overall prevalence of 36%, particularly high in scleroderma (75%) and MCTD (60%). Pulmonary arterial hypertension (PAH) was observed in 4%, primarily in systemic lupus erythematosus (9.5%). PFT abnormalities were common, with restrictive defects dominating in MCTD (100%) and scleroderma (87.5%). HRCT findings included reticulonodular lesions (14.7%), honeycombing (12%), pleural effusions (8%), and bronchiectasis (4%). Statistically significant differences in pulmonary complications were observed across CTDs subtypes. Conclusion. Pulmonary manifestations are prevalent in Sudanese CTDs patients, with ILD being the predominant complication. Early and systematic screening using PFTs and HRCT is crucial for timely detection and management. These findings highlight the need for enhanced multidisciplinary care and further research into regional variations in CTD-related pulmonary diseases.

The impact of pulmonary ventilation and oxygen therapy in the etiopathogenesis of bronchopulmonary dysplasia in premature infants

Svetlana SCIUCA , Aliona COTOMAN, Rodica SELEVESTRU — Tue, 09 Sep 2025 00:00:00 +0300

Bronchopulmonary dysplasia (BPD) is a chronic lung condition that frequently affects premature infants, characterized by damage to lung tissue and the need for prolonged oxygen or assisted ventilation. It usually occurs as a complication of mechanical ventilation and oxygen therapy administered to preterm infants, and its prevalence ranges from 20% to 40% among preterm infants.The purpose of the study was to evaluate the impact of pulmonary ventilation and oxygen therapy in the pathogenesis of bronchopulmonary dysplasia in premature children.Material and methods. The study represents an analysis of a cohort of 105 premature babies, with a history of premature birth and respiratory distress syndrome confirmed in the neonatal period, evaluated at the Pulmonology Clinic of the Mother and Child Institute. The study group included 53 children diagnosed with bronchopulmonary dysplasia, and the control group consisted of 52 children who did not develop BPD. All participants underwent an anamnestic and clinical-paraclinical evaluation. The diagnosis of BPD was established according to specific criteria.Results. Several factors related to the condition of the newborns were analyzed, such as gestational age (χ2=20.699; p<0.001), birth weight (F=42.173; p<0.0001), oxygen saturation level (F =26.305; p<0.0001), the need for oxygen therapy with artificial pulmonary ventilation (χ2=19;p<0.0001), which were associated with etiopathogenic mechanisms in the development of bronchopulmonary dysplasia in children born prematurely.Conclusions. Neonatal factors such as gestational age at birth, low birth weight in association with assisted ventilation and exaggerated O2 concentrations are pathogenically involved in the development of bronchopulmonary dysplasia in prematurely born children.

Endoscopic surgery combined with adjuvant radiotherapy in the treatment of T2 glottic carcinoma

Petru GURĂU, Oleg ARNAUT, Eusebiu SENCU, Dumitru SOFRONI — Tue, 09 Sep 2025 00:00:00 +0300

Thirty-nine patients with T2a glottic carcinoma who were followed up for 5 years after endoscopic surgical intervention met the study`s eligibility criteria. Nineteen patients from the examined cohort underwent only flexible endoscopic laser surgery (FELS), and 20 underwent postoperative radiotherapy (RT). FELS for T2 glottic carcinoma demonstrates comparable oncological results to RT and transoral laser microsurgery. The obtained results do not confirmthe supposed advantage of adjuvant RT in the endoscopic treatment of T2 glottic carcinoma.

Some comparative results of determining the hormonal correlations of AMH, T, LH, FSH in patients with (pcos) polycystic ovary syndrome

Victoria VOLOCEAI, Hristiana CAPROSH — Tue, 09 Sep 2025 00:00:00 +0300

Aim of the study. To study and establish the correlation between LH, T, FSH, AMH in PCOS and their impact on surgical treatment of PCOS. Material and methods. 138 clinical cases of patients selected according to the Rotterdam criteria regarding PCOS, who were admitted to the Aseptic Gynecology Department No. 1 of the Municipal Clinical Hospital No. 1 in the city of Chisinau, were analyzed. Each patient had a hormonal investigation before/after surgery to assess the impact of surgery on the change in the patient’s hormonal status. Results. The analysis showed that there is a strong correlation between LH, T, FSH, AMH in PCOS and that surgery contributes to changing the hormonal status of the patient with PCOS. Conclusion. The hormonal level has an impact on the impact of the surgical intervention.

Determining parameters of the cognitive disorders of the elderly population

Tue, 09 Sep 2025 00:00:00 +0300

Alzheimer’s disease often is due with different pathologies, defining the syndrome pathologies. As precocious symptom was identifyed determined losing progress of short-term memory, as one symptom more tardive irreversible loss of long-term memory, with association with combination with other cognitive disorders (aphasia-apraxia-agnosia). Cognitive unsettles represents an increasing problem in geriatic assessment complex. On the basis of geriatic increasing of 100 elderly persons from rural and urban, at the age of 65-95 years, from different localities of Moldova, the majority of patients being from department of Geriatrics Clinical Hospital of Ministry Health. The patients were evaluated depending on the cognitive level damage. From majority of population prevails female gender from rural, older 75 years, having the average level of training and activating as workers. At elderly patients prevail the presence of relatives that suffers of diseases of the nervous, that denotes hereditary etiology, but risk factors: alcohol, nicotine, injuries, fatigue.

Cardiovascular diseases: a public health problem in elderly in rural environments

Tue, 09 Sep 2025 00:00:00 +0300

Introduction. According to estimates, approximately 17.3 million deaths from cardiovascular diseases. Estimation of the impact of cardiovascular risk factors in the elderly patient taking into account the medico-social aspect. are registered annually. In the Republic of Moldova, in the general mortality structure of the population, cardiovascular diseases are in first place. Material and methods. 100 inhabitants of the Republic over 60 years of age (the maximum age being 94 years) were included in the study. Among them - 56 people (56%) constituted group I aged 60-69 years, 28 people (28%) - group II aged 70-79 years and 16 people (16%) - group III aged over 80 years. An individual evaluation sheet was completed for each person evaluated in the study. Results. The results of the complex and targeted study on this problem consist in the analysis of the situation regarding the morbidity and mortality due to cardiovascular diseases of the elderly population in the Republic of Moldova. identifying and estimating the impact of cardiovascular risk factors, as well as developing methods and strategies for their prevention and promotion in the context of primary and secondary care. Conclusions. Cardiovascular diseases are unanimously considered as one of the most important and pressing medical-social problems of the century. XXI, being responsible for 17.3 mln. deaths annually worldwide.

Improvement of the medical care quality for the patients with multiple and associated trauma

Anna KUSTUROVA, Mihai CIOCANU, Irina PALADII, Liviu VOVC, Vladimir KUSTUROV — Tue, 09 Sep 2025 00:00:00 +0300

Introduction. Improvement of the treatment quality in polytrauma patients remains an actual problem of modern medicine. Aim. To assess the effectiveness of providing medical care to victims of road traffic accidents (RTA). Material and methods. Treatment analysis of 210 patients with multiple and associated trauma who were admitted to the Institute of Emergency Medicine in 2009-2019 was conducted. Results. The introduction of minimally invasive surgical procedures has made it possible to achieve success in the treatment of victims after antraffic accident. Conclusions. Performing of the standards for emergency care in severe patients aftertraffic road accidents helps to improve the quality of treatment.

Frequency and etiologic structure of peritonitis

Tue, 09 Sep 2025 00:00:00 +0300

Introduction. Peritonitis remains a current problem in surgery, which is associated with high mortality - 20-30%, in severe cases reaching over > 70%. Aim. Etiologic analysis of peritonitis in the research group. Material and methods. Examination of 245 medical records of patients with peritonitis, treated in 2023, in Institute of Emergency Medicine, Chisinau. Results. Primary peritonitis in 11(4,48%) cases; secondary in 234 (95,51%), continious peritonitis in 9 patients.Death rate - 57 (23,26%) patients.Conclusions. The frequency and etiologic causes of peritonitis in the research group correspond to the literature data.

Use of criteria for post-covid-19 intracerebral thrombosis: a case series

Cornelia TURCAN , Oxana GROSU, Lilia ROTARU, Stela ODOBESCU, Ion MOLDOVANU — Tue, 09 Sep 2025 00:00:00 +0300

The diagnosis of post-COVID-19 cerebral venous thrombosis (CVT) in adults is made according to the following criteria: (1) age ≥18 years; (2) CVT confirmed by imaging or autopsy; (3) COVID-19 confirmed by PCR test 90 days before CVT diagnosis or during hospitalization.Purpose of the paper: Analysis of the utility of diagnostic criteria for establishing the diagnosis of post-COVID-19 cerebral thrombosis. Material and Methods: The cases of all patients suspected of CVT, admitted to the Institute of Neurology and Neurosurgery “Diomid Gherman” in 2020 - 2023 were evaluated. The application of diagnostic criteria was analyzed. Results and discussions: 5 patients aged 30-66 years were identified, diagnosed with post-COVID-19 CVT confirmed by PCR test. Complaints presented upon admission were: sudden onset severe headache, diplopia, retroorbital pain, exophthalmos, ataxia. Investigations performed were: computed tomography (CT) angiography, contrast-enhanced cerebral magnetic resonance imaging (MRI), digital subtraction angiography of the head, classical angiography. CVT was determined at the level of the transverse and cavernous sinus. The average time from confirmation of COVID-19 to the onset of CVT was 93 days. Of these patients, one presented ischemic stroke with hemorrhagic transformation in the vertebrobasilar system, user of oral contraceptives, with a history of migraine with aura; another presented secondary bacterial meningitis. Anticoagulant treatment was initiated, and some patients additionally received antibiotics. Conclusions. Cerebral venous thrombosis should be suspected in all post-COVID-19 patients. The use of diagnostic criteria can facilitate early diagnosis and prompt and correct therapeutic approach to patients.

Knowledge of doctors in the management of the patients with Parkinson disease in the Republic of Moldova

Irina RUSU, Madalina CEBUC, Oxana GROSU , Galina CORCEA , Lilia ROTARU — Tue, 09 Sep 2025 00:00:00 +0300

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s disease with a great medical, economic and social impact in the world, including the Republic of Moldova. Extensive, up-to-date theoretical and practical knowledge of the doctor is strictly necessary for a more accurate and productive approach for both the patient and his family.Objective of the study. Analysis of the knowledge of neurologists in the management of patients with Parkinson’s disease in the Republic of Moldova. Material and methods. An observational study was conducted where doctors completed a questionnaire with 34 questions for 15 minutes. The results were statistically analyzed. Results. 105 questionnaires were completed, of which 72,4% are women, 27,6% are men, 82,9% are urban and 17,1% are rural. 92,4% do not have a scientific degree and 7,6% have a scientific degree. Of the total respondents, 57.1% said they know national and/or international guidelines/protocols for the treatment of Parkinson’s disease. 79% mentioned that they know that patients with Parkinson’s disease require not only drug treatment but also non-drug management, and 56,2% know scales for measuring the severity of Parkinson’s disease. In the last 5 years 64,8% did not receive training on Parkinson’s disease management, and 35,2% benefited: 11,4% attended the training course in the country, 22,9% - training course abroad, 12,4% attended the national congress, 13,3% at the international congress, 21,9% participated in lessons organized by the professional society. However, a large percentage of respondents say they have insufficientknowledge to work effectively with patients with Parkinson’s disease in its early phase (46,7%), patients with Parkinson’s disease who have already developed motor complications (49,5%), patients with Parkinson’s disease and cognitive and behavioral disorders (47,6%). Of these, 75,2% responded that they need additional theoretical knowledge in the management of Parkinson’s disease patients, while 58,1% consider the lack of training/improvement in the field of movement disorders a major problem.Conclusions. The knowledge of neurologist doctors in the Republic of Moldova is considered by most of them insufficient. There is a strong need to broaden knowledge opportunities both nationally and internationally.

Intravenous thrombolysis in patients with acute ischemic stroke: institutional retrospective cohort study

Tue, 09 Sep 2025 00:00:00 +0300

Ischemic Stroke represents a major medical emergency, ranking second place after ischemic heart disease in the structure of mortality and disability of the population at national and global level. This article represent a retrospective study. It were selected and analized a total of 126 medical records of patients diagnosed with acute ischemic stroke undergoing intravenous thrombolysis. These patients were admitted to the Diomid Gherman Institute of Neurology and Neurosurgery between 2019 and 2023. The study included 61 men (48.41%) and 65 women (51.59%), with a mean age of 69±8.5 years. The identified risk factors in these patients were arterial hypertension, diabetes mellitus, obesity, and cardiac rhythm disorders (atrial fibrillation).Patients who arrived at the Diomid Gherman Institute of Neurology and Neurosurgery within 4.5 hours of symptom onset, displayed specific clinical symptoms, and had no signs of intracerebral hemorrhage or ischemia on cerebral CT were included in the study and received revascularization treatment with rtPA. The NIHSS score at admission was 14 points, which decreased to 10 points after thrombolysis. An improvement in the NIHSS score was observed in 70.62% of patients, with an average reduction of 10 points (minimum 3 points - maximum 17 points) after rtPA administration. Among patients whose NIHSS score remained the same or worsened (a total of 44 patients), 30 deaths (24.59%) were recorded, predominantly in patients with severe comorbidities or an initial NIHSS score >17 points. The implementation of intravenous thrombolysis in patients with acute ischemic stroke proved effective, contributing to the reduction ofneurological deficit severity, and increasing recovery rates. However, the results of this study highlight the importance of early diagnosis of stroke signs and symptoms and the need to optimize the emergency system to facilitate faster access to treatment.

Methodology of remote ischemic conditioning in patients with cerebral cardioembolism

Mihail GAVRILIUC, Rodica LUCHIANCIUC — Tue, 09 Sep 2025 00:00:00 +0300

In recent years, the treatment of acute ischemic stroke has seen significant progress due to the increased use of intravenous thrombolysis and mechanical thrombectomy. This article examines whether non-pharmacological neuroprotective therapy remains relevant in the current context of reperfusion treatments. The article discusses various types and possible mechanisms of neuroprotection triggered during and after remote ischemic conditioning. The analysis includes the results of a case-control clinical study aimed at evaluating the clinical efficacy of the remote ischemic conditioning procedure in patients with cardioembolic stroke. The study included 138 individuals with ischemic cardioembolic stroke and those without ischemic cardioembolic stroke but with risk factors for cerebral cardioembolism, who underwent the remote conditioning procedure.

DIGITALISATION OF HEALTH DATA: IMPACT ON PATIENT-CENTREDNESS AND SAFETY

Constantin PISARENCO, Serghei PISARENCO — Tue, 09 Sep 2025 00:00:00 +0300

The article explores the effects of health data digitalisation on patient-centred care and data security. Innovations such as electronic health records, telemedicine, and mobile applications improve accessibility and patient engagement in decision-making. However, these advancements raise concerns about cybersecurity, privacy protection, and ethical issues. The authors emphasise the importance of implementing international standards to safeguard data confidentiality and recommend developing robust digital infrastructures and enhancing the legal literacy of healthcare professionals to address the technological and legal challenges of digitalisation.

The tendency to take risks in medicine: factors and prevention of adverse outcomes

Constantin PISARENCO, Mihaela MANEA , Serghei PISARENCO — Tue, 09 Sep 2025 00:00:00 +0300

The study focuses on the impact of risk aptitude on health professionals’ professional behaviour and related outcomes. High levels of risk appetite increase the likelihood of deviations from standard protocols, which can lead to adverse patient outcomes. Key factors including stress, burnout and the experience of professionals are analysed. Prevention measures such as developing a culture of safety, implementing reporting systems and psychological support programmes are suggested. These strategies aim to reduce risky behaviour and improve overall safety in medical practice.

Characteristics of some clinical and paraclinical features of patients with bronchial asthma in the post-COVID-19 period

Larisa PROCOPIȘIN, Vasile ANTIPA, Valeriu DJUGOSTRAN — Tue, 09 Sep 2025 00:00:00 +0300

The analysis of cases with bronchial asthma in the post-COVID-19 period highlights the frequency of respiratory, cardiovascular and neuropsychiatric symptoms, increased inflammatory biochemical markers, dysregulation of pulmonary respiratory function. Elderly patients with asthma in the post-COVID-19 period exhibit some peculiarities, such as high comorbidity, use of a large number of medications, individualized response to treatment, different perception of symptoms and a higher mortality rate. These aspects emphasize the need to maintain optimal asthma control and prevent exacerbations that can accelerate the progression to respiratory failure. Further research is needed to effectively address issues related to different asthma phenotypes, treatment intensity and degree of disease

Brixia scorepredictor of lung injury in patients with SARS-Cov-2 infection

Natalia CERNEI — Tue, 09 Sep 2025 00:00:00 +0300

Aim. Description of a systematic review about the Brixia score, the rapid quantification of the severity of COVID-19, its diagnostic and clinical significance, its role in the stratification of this category of patients. Material and methods. Publications were selected from PubMed, Hinari, SpringerLink and Google Search databases that highlighted the main aspects of the Brixia Score in correlation with SARS-Cov-2 infection. Results. Brixia radiological quantification correlates positively with other clinical (body mass index, age, comorbidities, PaO2/FiO2 ratio, SpO2 values) and paraclinical (C-reactive protein, D-dimers) indicators, and can be considered a predictor of severity and mortality. Conclusions. In the complex management of the infected patient, the assessment of the progression and severity of COVID-19 by the Brixia score plays a crucial role in clinical decision - making.

TB and HIV: A Double Burden in Public Health

Igor IVANES — Tue, 09 Sep 2025 00:00:00 +0300

The TB/HIV coinfection represents a major global public health challenge, with severe implications for morbidity and mortality. The complex interaction between these two conditions significa ntly increases the risk of rapid progression for both diseases. Recent studies highlight the need for early diagnosis using advanced methods, such as rapid molecular tests, and timely initiation of antiretroviral therapy to reduce incidence and mortality. Integrated strategies, including prevention and personalized treatment, are essential, especially in the context of drug-resistant forms. Despite progress, challenges related to stigma, limited access to treatment, and drug interactions require ongoing efforts to improve clinical outcomes.

The complex approach of risk factors in the emergence of developmental disorders in children of young age

Tue, 09 Sep 2025 00:00:00 +0300

Neurological development is the foundation of the learning process and is essential for brain maturation. Brain development is a complex process that begins early, prenatally, and continues throughout life, consisting of a series of complex biological processes that shape the development of the nervous system, such as the formation of neurons, synapses, and neural circuits, as well as the establishment of neural communication pathways, the final product of which is the formation of brain structures, the development of skills and the individual configuration of each child. Optimal early childhood development spans diverse domains, including physical, social-emotional, and linguistic-cognitive aspects. Timely identification of at-risk children is of critical importance, as prompt referral to specialist interventions reduces the likelihood of long-term problems and improves outcomes in adulthood. Ensuring early access to interventions is a key priority in addressing developmental delays. Estimating prevalence and understanding specific types of delays are essential initial steps in early intervention planning.

Pulmonary rehabilitation in diffuse interstitial lung diseases: evidence and clinical applications

Tue, 09 Sep 2025 00:00:00 +0300

Diffuse interstitial lung diseases (ILD) are a heterogeneous group of diseases characterized by inflammation and fibrosis in the pulmonary interstitium, significantly affecting the gas exchange capacity and quality of life of patients. The most common forms of ILD include idiopathic pulmonary fibrosis (IPF), sarcoidosis, and interstitial pneumonias associated with autoimmune diseases, all of which have a considerable impact on respiratory function. The management of ILD is complex, including pharmacological treatments and non - pharmacological interventions, such as pulmonary rehabilitation (PR) programs, essential for the improvement of symptoms and quality of life.Pulmonary rehabilitation involves physical training, patient education, and psychosocial support, aiming to increase exercise tolerance and reduce symptoms. RR is tailored to the individual needs of patients, taking into account the severity of hypoxemia and associated comorbidities. Recent studies suggest that RR can have a significant positive impact on patients with ILD, even in advanced forms of the disease.Pulmonary rehabilitation programs are performed by multidisciplinary teams and require detailed assessments for appropriate adjustment of the exercises. The core component includes aerobic and strength exercises, adapted to prevent desaturation and excessive fatigue. Psychological support is also essential, given that patients frequently experience anxiety and depression.Through a personalized approach, pulmonary rehabilitation offers patients with ILD an effective way to manage symptoms, thereby improving residual lung function and quality of life. This intervention is becoming an integral part of the care of patients with progressive lung disease, with documented long - term benefits.

The role of leadership in identifying organizational culture in hospital units

Ludmila GOMA , Nina GLOBA , Fiodor GREJDEAN , Buga MIRCEA — Tue, 09 Sep 2025 00:00:00 +0300

The article examines the impact of organizational culture on leadership in healthcare institutions. Here it highlights the existence of the relationship between organizational culture, leadership behavior (leadership), job satisfaction and quality of health care. It is pointed out that the interdependence between the type of organizational culture and job satisfaction of medical workers affects many aspects, including patients, coworkers, quality of medical service.It is concluded that effective leadership is influenced by the definition of organizational culture which in turn contributes to improving the quality of medical service, and hospital employees would prefer to work in an environment with an innovative, positive, task-oriented culture.

Concealing Colleagues’ Medical Errors by Physicians: Ethical and Legal Challenges, Responsibility, and Consequences

Constantin PISARENCO, Diana CONDRATCHI — Tue, 09 Sep 2025 00:00:00 +0300

The concealment of colleagues’ medical errors raises ethical and legal debates in healthcare. This study aimed to analyze these aspects and offer recommendations for medical practice. The research used PubMed, Google Scholar, and legal documents, applying content analysis and comparative legal methods. Findings showed that error concealment reduces patient trust, lowers care quality, and increases litigation risks. The importance of fostering an open culture to prevent error concealment was confirmed. Recommendations include monitoring and supporting physicians in error acknowledgment. Conclusions highlight the need for transparency to enhance patient safety.

The role of genetic factors in the development of tuberculosis relapse

Elena TUDOR — Tue, 09 Sep 2025 00:00:00 +0300

Tuberculosis remains a global problem for health, with substantial rates of mortality worldwide. This literature review examines the current progress in studying polymorphisms associated with tuberculosis susceptibility, including genome studies. It was also addressed how these findings align with genetic polymorphisms that are associated with resistance to developing tuberculosis. Despite the progress, there is insufficient data on the role of genetic factors in the development of tuberculosis relapse, highlighting the need for further investigations.

Immune aspects in tuberculosis relapse

Elena TUDOR — Tue, 09 Sep 2025 00:00:00 +0300

The relapse of tuberculosis is associated with the host’s immune system failure to control the body’s immune response to Mycobacterium tuberculosis. Expressed immune disorders characterize the recurrence of tuberculosis, data reflected in contemporary specialized literature. The knowledge of the immunological mechanisms characteristic of the recidivism of tuberculosis can facilitate the rational selection of immunoterapeutic medication, the design of effective vaccines and the evaluation of their effectiveness, the evaluation of new drugs and in the development of new immunodiagnostic tools.

THE ROLE OF MICRO-RNA IN ATHEROSCLEROSIS

Tue, 09 Sep 2025 00:00:00 +0300

Introduction. Micro-RNA (miRNA) are small ribonucleic acid (RNA) molecules that play a crucial role in regulating gene expression in eukaryotic cells. Currently, circulating microRNAs are considered promising biomarkers for diagnosis and potential therapeutic targets for treating cardiovascular diseases, including atherosclerosis. Materials and Methods. A literature review of the last 10 years was conducted, using 30 bibliographic sources, including those from the “Nicolae Testemițanu” USMF Scientific Medical Library and electronic libraries such as PubMed, Elsevier, Cambridge Journals Online, Hinari, Medline, and MedScape. Results. A number of studies have estimated the major role of miRNAs in the diagnosis and treatment of atherosclerosis. Hepatic overexpression of miR-30c significantly reduced atherosclerosis by decreasing cholesterol and ApoB-lipoprotein synthesis. Another study supports the conclusion that miR-30c-5p substantially protects human aortic endothelial cells from the cell death through pyroptosis. In one study, the administration of miR-23a-5p had a major impact on protection against atherosclerosis progression and improving plaque stability in dyslipidemic mice. Conclusions. miRNAs play a major role in regulating molecular processes that contribute to the development and progression of atherosclerosis, including apoptosis, inflammation, and lipoprotein metabolism. Identifying specific microRNAs as biomarkers and therapeutic targets opens new perspectives for the development of more effective treatments and early diagnostic methods for atherosclerosis.

Suspected autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) - clinical case

Madalina CEBUC, Marina SANGHELI , Irina CERNEI, Galina CORCEA — Tue, 09 Sep 2025 00:00:00 +0300

The autoimmune neuropsychiatric disorder associated with streptococcal infection (PANS/PANDAS) is a rare subtype of idiopathic autoimmune encephalitis that manifests as recently developed tics and obsessive - compulsive disorder following an infection with Group A beta - hemolytic Streptococcus. This clinical case illustrates a rare situation of suspected PANDAS and highlights the need for national management protocols for autoimmune neurological pathologies.

Spinal Arterio-Venous Malformations: Clinical Case and Literature Review

Tue, 09 Sep 2025 00:00:00 +0300

Vascular malformations of the spinal cord, namely arteriovenous malformations (AVMs) and fistulas (AVFs), account for less than 5% of intraspinal pathology and cause severe and progressive symptoms. Ultimately, this rarity and heterogeneity of AVMs leads to very diverse treatment options that depend on AVM classification. They represent a developmental abnormality of the vascular system, which is a tangle of poorly formed blood vessels in which the feeding arteries are directly connected to a network of venous drainage without any intervening capillary system. They can occur anywhere in the body, but of major importance are the cerebral and spinal, having a major risk of causing serious neurological damage and can present diagnostic and therapeutic challenges for the radiological and surgical teams. The evaluation of these injuries can be further complicated by the lack of a universally accepted classification scheme. Early diagnosis improves outcomes because patients can benefit from early intervention.

Pulmonary embolism in postmenopausal women: a case report

Tue, 09 Sep 2025 00:00:00 +0300

This study presents the case of a 73-year-old female patient with multiple cardiovascular comorbidities. The case’s particularities include nonspecific symptoms, delayed presentation, and a dramatic outcome despite the implementation of complex treatment, including anticoagulation. The literature review focused on the following aspects: the incidence and severity of PE in women versus men, the role of comorbidities in influencing PE risk, and differences in thrombolysis usage.

Subclinical pulmonary thromboembolism in the context of cardiovascular pathology: a case report

Tue, 09 Sep 2025 00:00:00 +0300

The aim of the study was to present a case of a 72-year-old man with pulmonary thromboembolism in the context of cardiovascular pathology. This case report highlights the importance of early diagnosis and treatment to prevent fatal outcomes. Identifying pulmonary thromboembolism in cases of cardiovascular pathology can be challenging due to overlapping symptoms, the influence of treatment on diagnostic tests, and difficulties in interpreting imaging investigations.

Skene’s gland cyst

Ana MISHINA , Patricia HAREA , Ala SUMAN — Tue, 09 Sep 2025 00:00:00 +0300

Skene glands, also known as the paraurethral glands, are located inferolaterally on either side of the female urethra and are considered the female homolog of the male prostate, originating from the urogenital sinus. Skene gland abnormalities are infrequent and the incidence is unknown. The authors presented a clinical observation of a Skene gland cyst and a narrative review of the literature on this pathology.

Entero-scrotal faecal fistula as a complication of strangulated inguinal hernia

Elina SHOR, Igor MISHIN — Tue, 09 Sep 2025 00:00:00 +0300

Entero-scrotal faecal fistula is a very rare presentation or complication of strangulated inguinal hernia. A systematic literature review was performed, according to the PRISMA statement from PubMed and Google Scholar with the identification of 20 cases reported in the period 1993-2023 and most of these cases published were from developing countries. Elective repair of inguinal hernias is the most efective way to prevent complications (morbidity and mortality).

Nasopharyngeal carcinoma - problems and solutions

Natalia TABAC — Tue, 09 Sep 2025 00:00:00 +0300

The aim: to highlight nasopharyngeal carcinoma (CN) as a medico-social and clinical problem, solutions. Materials and methods: the study included current bibliographic studies and their analysis, 26 CN patients, with a mean age of 46.5±0.5 years. Patients were evaluated clinically, paraclinically, CT scans, MRI, PET, laboratory investigations, histopathological analyses. Results. CN patients were 7 women (26.9%), 19 (73.7%) men with an average age of 46.5 years. 26 (100%) were examined clinically and paraclinically, CT - 25(96.1%), MRI - 26 (100%), PET - 22(84.6%), which demonstrated radiological and imaging changes characteristic of CN . Metastases were confirmed in 18 patients (69.2%). Histopathology analyzes - G1 - 5(19.3%), G2 - 15(57.7%), G3 - 6(23.0%), keratinized type 7 (26.9%) and non-keratinized - 19 (73.1%). Epstein Barr virus was positive in 13 (50%) patients.Conclusions. The following risk factors were identified in the 26 patients with CN - excessive consumption of food preserved with salt - 24 (92.3%), smoking - 6 (23%), Epstein Barr virus (EBV) - 12 (46.1 %). CN development also depends on genetic factors and latent membrane proteins and other molecules - tumor antigens. Advanced imaging technologies such as MRI and PET-CT can improve the early detection of CN. Also, the development of specific biomarkers for CN could allow early diagnosis through blood or saliva tests. Better access to these technologies in resource-limited regions could have a significant impact on patient outcomes.

Dietary principles for patients with pregnancy-associated breast cancer

Corneliu URECHE, Vladimir CARAUSH — Tue, 09 Sep 2025 00:00:00 +0300

Background: The nutritional management of pregnant women with breast cancer is crucial to ensure the health of both the mother and the fetus. The interplay between cancer progression, pregnancy, and diet poses unique challenges that require a comprehensive approach to treatment. Objective: To review the international scientific perspectives on the dietary principles best suited for managing pregnant women with breast cancer, focusing on balancing maternal and fetal health, minimizing side effects of cancer treatments, and maintaining optimal nutritional status. Methods: An extensive review of current international scientific literature was conducted to identify key dietary components, nutritional interventions, and guidelines that influence outcomes for pregnant breast cancer patients. Results: An optimal diet is characterized by adequate energy intake, high-quality proteins, omega-3 fatty acids, micronutrients, and antioxidant-rich foods, while avoiding carcinogenic, pro-inflammatory, and hormonally active foods. Conclusion: Nutritional therapy for pregnant women with breast cancer requires an individualized, evidence-based approach, aimed at optimizing maternal and fetal health, supporting cancer therapy, and enhancing prognosis. Further research is needed to establish standardized dietary protocols.

Some ways of analyzing the health insurance system: reflections and suggestions

Efim ARAMA, Natalia GASHITOI, Svetlana LOZOVANU, Andrei GANENCO — Tue, 09 Sep 2025 00:00:00 +0300

Premises: The article analyzes how different authors address the healthcare insurance system in the Republic of Moldova. It identifies and examines factors impacting human health. Among these relevant factors, the environment is highlighted as a contributor to the increase in the number of patients, as it can, in some cases, become a generator of diverse health risks for the population. Objectives: The authors suggest taking into account various health risks for the population and exploring ways to improve public health using advanced technologies and mathematical methods. Materials and Methods: Statistical data from the National Bureau of Statistics served as the material for the study.Analysis and mathematical calculations were employed as methods.Results: The article analyzes the birth-mortality balance per 1,000 inhabitants in the Republic of Moldova. It characterizes the statistical distribution of basic funds by types of medical activities and identifies components of the healthcare system in the Republic of Moldova, including informational, medical, and managerial systems. Based on statistical data, the article quantifies correlative dependencies and proposes an algorithm for calculating regression equation parameters. Conclusions: Between 2003 and 2018, the Republic of Moldova recorded a negative birth-mortality balance, meaning that the birth rate per 1,000 inhabitants was lower than the mortality rate. The issue of this balance could be partially addressed by optimizing the allocation of basic funds among different types of medical activities. To this end, analyzing the dependence of mortality on types of medical activities is necessary. Developing a system of regression equations could contribute to redistributing some funds to reduce the mortality rate.The proposed material is of interest to a wide range of readers, including potential patients.

THE ADAPTABILITY OF THE HUMAN BEING TO THE RAPID CHANGES OF CONTEMPORARY SOCIETY

Ion, Gheorghe DUCA, Daria BERECTARI — Tue, 09 Sep 2025 00:00:00 +0300

The article presents the context of the rapid changes in contemporary society - technology, globalization, social and economic crises. Human adaptability and its importance in the face of these changes are defined.The psychological and sociological theories related to adaptability and resilience and the models of adaptation and coping - stress-adaptation, individual vs. collective resilience, etc. are analyzed. The authors also analyze the specific changes in contemporary society and the impact on adaptability, digitalization and the impact of technology on daily life, global mobility and cultural diversity, including strategies for developing adaptability - psychological interventions: mindfulness techniques, stress management, coping skills development; social policies: social support programs, adaptive education, preparation for change; The role of technology in improving adaptive capacity.

HER2/NEU AND CD3 EXPRESSION IN BREAST CANCER ASSOCIATED WITH DIABETES

Tue, 09 Sep 2025 00:00:00 +0300

Breast cancer is one of the most common neoplasms globally, being responsible for a high mortality rate, especially in the presence of comorbidities such as diabetes mellitus (DM). In this context, molecular markers such as CD3 and HER2/neu play an essential role. CD3 is a crucial protein for the function and activation of T cells, playing a central role in antitumor immunity. Similarly, the HER2/neu receptor, a member of the epidermal growth factor receptor (EGFR) family, is directly involved in processes of cellular proliferation, angiogenesis and tumor aggressiveness in breast cancer. The aim of this study was to evaluate the expression of CD3 and HER2/neu markers in NST (non-special type) breast carcinomas in patients with and without type 2 DM. The analysis focuses on correlating the expression levels of these markers with the presence of diabetes mellitus and the clinicopathological characteristics of the tumors.

Evaluation of Magnetic Resonance Imaging in the detection of lumbar disc herniations in relation to clinical signs

Victoria SEU, Oxana MALIGA — Tue, 09 Sep 2025 00:00:00 +0300

Introduction: In clinical practice, the diagnosis of lumbosacral radiculopathy involves clinical neurological examination and imaging examination. Clinical neurological tests include sensory, motor, reflex, neurodynamic testing. The MRI examination is the most informative method in the diagnosis of disc herniation, especially for determining the presence, location, shape of the herniation. The role of MRI in the diagnosis of radiculopathy is limited, by visualizing only disc herniations and spinal canal stenosis. Material and methods: The study included 51 patients with signs of lumbar neurocompressive syndrome. All patients underwent a clinical neurological examination in the Department of Neurosurgery and an MRI examination of the lumbar spine that was performed using a Siemens Magnetom Skyra machine. Results: Multivariate analysis suggested a correlation between disc protrusions and gait disorders, but the significance threshold was only 10% (p < 0.10%). Disc extrusions, however, demonstrated a significant correlation with gait disturbances and loss of sensation in the lower limb (p < 0.05%). The multivariate analysis of disc extrusions at various levels revealed a significant correlation between L4-L5 and L5-S1 intervertebral disc extrusions with gait disorders (p=0.042) and muscle weakness in the lower limb (p=0.019). Conclusions: Indications for performing MRI are found to be lumbar pain, sensory deficit, and motor weakness. Specific clinical tests, neurological examination, examination of osteotendinous reflexes, Lasegue maneuver, determination of sensory disorders and of motor deficit are recommended to precise the indications. In the absence of neurological disorders, the MRI examination is not recommended.