North-Eastern Region Of Romania Research Articles

Antiretroviral Therapy Switch in HIV-Infected Adults from a Regional HIV/AIDS Center in NE Romania.

Background and Objectives: Antiretroviral therapy (ART) has revolutionized the management of HIV infection, transforming it from a once-debilitating disease to a chronic, manageable condition. However, challenges such as treatment resistance, medication side effects, and long-term tolerability persist, prompting the exploration of novel therapeutic approaches. We aimed to highlight the characteristics and related comorbidities of HIV/AIDS cases in which the antiretroviral therapy was modified. Material and Methods: A cross-sectional clinical investigation was conducted on adults diagnosed with HIV/AIDS who were hospitalized at the "St. Parascheva" Clinical Hospital of Infectious Diseases in Iasi in the Northeastern region of Romania. The timeframe under investigation was 1 January 2023 to 30 June 2023. Results: In the Northeastern part of Romania, from a total of 1692 patients in the active records, there were a total of 148 recorded cases of antiretroviral therapy switch in HIV-infected patients. The main reason for the ART switch was the simplification of the ART regimen (82 cases, 55.40%), viro-immunological failure (16 cases, 10.66%), other disturbances correlated to the ART regimen, dyslipidemia (34 cases 22.97%), depression (3 cases, 2.02%), suicide attempt (1 case, 0.67%), new situations, including the appearance of pregnancy (3 cases 2.02%), and tuberculosis (9 cases, 6.08%). ART before the switch was represented by protease inhibitors that accounted for 84 cases (56.75%) of the ART switch. Following the therapy switch, integrase inhibitor-based ART single-tablet regimens accounted for 43.91% (65 cases) of all changeovers, with non-nucleoside reverse transcriptase inhibitor regimens coming in second, in 63 cases, 42.66%. Conclusions: ART switch as an experimental therapy offers a promising approach to optimizing HIV treatment outcomes. By focusing on viral suppression and immune reconstitution, addressing treatment challenges, and exploring novel ARV agents, ART switch strategies aim to improve the overall health and well-being of individuals living with HIV.

Casting Light on The Hidden Prevalence: A Novel Perspective on Hypoplastic Coronary Artery Disease.

Background and Objectives: Coronary artery anomalies (CAAs) represent a group of rare cardiac abnormalities with an incidence of up to 1.2%. The aim of this retrospective study was to conduct a comprehensive epidemiological assessment of the prevalence of hypoplastic coronary arteries using coronary computed tomography angiography (CCTA) in patients with diagnosed CAAs and individuals presenting with cardiovascular manifestations in the north-eastern region of Romania. This study was motivated by the limited investigation of the CAAs conducted in this area. Methods: We analyzed data collected from 12,758 coronary computed tomography angiography (CCTA) records available at the "Prof. Dr. George I.M. Georgescu" Cardiovascular Diseases Institute, spanning the years 2012 to 2022. Results: Among 350 individuals with CAAs (2.7% of the total cohort), 71 patients (20.3% of the anomaly presenting group and 0.5% of the entire CCTA cohort) exhibited at least one hypoplastic coronary artery. The mean age of individuals diagnosed with hypoplastic coronary artery disease (HCAD) was 61 years, while the age distribution among them ranged from 22 to 84 years. Nearly equal cases of right and left dominance (33 and 31, respectively) were observed, with only 7 cases of co-dominance. Conclusions: HCAD may be considered underexplored in current published research, despite its potentially significant implications ranging to an increased risk of sudden cardiac arrest. The specific prevalence of HCAD among CAAs might be higher than previously reported, possibly reflecting better diagnostic accuracy of CCTA over classic coronary imaging. The absence of standard diagnostic and therapeutic protocols for HCAD underscores the necessity of a personalized approach for such cases.

WCN24-838 Prevalence of chronic kidney disease among elderly patients in North-Eastern Region of Romania: A Cross-Sectional Retrospective Analysis

WCN24-838 Prevalence of chronic kidney disease among elderly patients in North-Eastern Region of Romania: A Cross-Sectional Retrospective Analysis

Epidemiological and histopathological aspects of ocular melanomas in Northeastern Romania.

Ocular melanoma is a rare but complex disease in current medical practice. Our retrospective study spans over a period of 28 years and analyzed uveal and conjunctival melanomas that were consecutively admitted, diagnosed, and treated in the 2nd Ophthalmology Clinic of Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iaşi, Romania. The patients were selected from the records of the Department of Pathology of our Hospital, being diagnosed by standard histopathological techniques. The aim of this study was to summarize the epidemiological and pathological aspects of uveal and conjunctival melanomas in Northeastern region of Romania. In our study, we did not notice a predilection of uveal and conjunctival melanoma to one particular gender. The most common histological subtypes of ocular melanomas were the heavily pigmented spindle cell subtype, followed by the epithelioid subtype. Our patients sought medical help in a timely manner, before the systemic invasion of the disease could develop.

Students’ Perceptions on Online Teaching and Learning in Higher Education

Virtual environments allow teachers to approach the teaching process inclusively and creatively, to facilitate the effective transfer of learning and to support student learning with new technologies regardless of various barriers. The hereby study evaluates the students’ views concerning the virtual delivery of courses during their learning process taking into consideration their former face-to-face teaching-learning experience. It was based on the theoretical part which included typical aspects of online teaching and learning are presented and the most recent studies in this area are reviewed. Following previous research, we aim to develop an innovative model of successful online teaching and learning in higher education. A questionnaire-based research methodology was designed for 355 students at a university in the North-Eastern region of Romania. The questionnaire with closed-ended items was used for assessing students’ attitudes on the online teaching activity. The results indicate students’ preference for online courses, as well as a number of significant differences, depending on the study specialisation or form of education. Any future changes to online teaching and learning in universities should also take into account students’ and teachers’ views on this particular issue. Such an approach should allow us to see whether and how effective the use of virtual teaching environments can be for both students and teachers in higher education (HE).

Participatory sociolinguistics across researchers’ and participants’ language ideologies

ABSTRACT The participatory approach is becoming more widespread in the social sciences and is also starting to take hold in the study of language in society. However, there has been little research done on how critical sociolinguistics can be linked to research that is based on the involvement and engagement of as many participants as possible at a level they find relevant for themselves. We argue that the academic separation between the ‘researcher’ and the ‘researched’ is worth reexamining in sociolinguistic research, as all participants do ’ideologizing work’ that establishes the perspective from which they view language. We discuss this through a case study from Moldavia, the North-Eastern region of Romania, which aimed to explore the contemporary language practices of former students of a Hungarian-language revitalization program. We point out that being critical of language-related inequalities cannot be separated from being critical of participation in the research process, if we are to work together across a multiplicity of language ideologies.

Epidemiological Study of Autoimmune Bullous Dermatoses in Northeastern Romania.

Autoimmune bullous diseases (ABDs) are a rare but significant group of dermatoses that pose great challenges to the treating dermatologist. ABDs are characterized by the presence of tissue-bound and circulating autoantibodies directed against disease-specific target antigens of the skin. Most epidemiological studies have focused on a single ABD. More than that, there are few data about the incidence and prevalence of autoimmune blistering diseases in Romania. In this study, between 2015 and 2019, we retrospectively investigated a total of 225 patients with autoimmune bullous diseases from the northeastern region of Romania. The diagnosis was based on the clinical and histo- and immunohistological findings. Pemphigus was the most frequently encountered ABD, with an incidence of 8.16/1,000,000 inhabitants, representing 58.7% (132 cases), followed by 24% cases of bullous pemphigoid (54 cases), 15.4% of patients were diagnosed with dermatitis herpetiformis (37 cases), and 0.9% other subepidermal autoimmune bullous dermatoses. The average age of onset of pemphigus vulgaris was 59.4 years, the majority of patients being male, while the average age of patients diagnosed with bullous pemphigoid was 73.8 years, the majority being female. Pemphigus vulgaris is the most frequently encountered ABDs in the northeast of Romania, with a higher incidence than in Western European countries, and this may be due to specific peculiarities of the geographical area, as well as to a genetic susceptibility of the population in this region.

Follow-up care after metabolic surgery – a prospective study in the North-Eastern region of Romania

Follow-up care after metabolic surgery – a prospective study in the North-Eastern region of Romania

Exploring Microbiota Diversity in Cervical Lesion Progression and HPV Infection through 16S rRNA Gene Metagenomic Sequencing.

(1) Background: Cervical cancer is a significant health concern, with the main cause being persistent infection with high-risk Human Papillomavirus (hrHPV). There is still no evidence for why viral persistence occurs in some women, but recent studies have revealed the interplay between cervical microbiota and hrHPV. This research aimed to characterize the cervicovaginal microbiota in cervical lesion progression and HPV infection status. (2) Methods: This study included 85 cervical specimens from women from the north-eastern region of Romania. DNA was isolated from cervical secretion for HPV genotyping and 16S ribosomal RNA gene NGS sequencing. (3) Results: Our study revealed a distinct pattern within the studied group when considering Lactobacillus species, which differs from findings reported in other populations. Specifically, the presence of Lactobacillus iners coupled with the absence of Lactobacillus crispatus alongside Atopobium spp., Prevotella spp., and Gardnerella spp. could serve as defining factors for severe cervical lesions. The results also showed a significant association between microbiota diversity, HPV infection, and cervical lesion progression. (4) Conclusions: As the microbiota profile seems to vary among different populations and individuals, a deeper comprehension of its composition has the potential to develop personalized detection and treatment approaches for cervical dysplasia and cancer.

Geo-hazards assessment and land suitability estimation for spatial planning using multi-criteria analysis

The fundamentals contribution of multi-hazard assessment lies in its ability to guide and identify directions for territorial development, aiming to reduce vulnerability through the implementation of appropriate measures. In the present study, Multi-Criteria Decision Making supported by Geographic Information System was utilized to solve spatial problems related to territorial sprawl. Considering this perspective, an analysis was conducted on the susceptibility of land to the occurrence of geo hazards in the Moldova catchment, situated in the northeastern region of Romania, within a transitional zone between mountains and plateaus. The analysis focused on assessing the likelihood of geo-hazards like floods, landslides, and earthquakes, utilizing the weights obtained through the implementation of the Analytical Hierarchy Process (AHP). Subsequently, the obtained results were utilized to generate a multi-hazard map, which facilitated the identification of areas that are suitable for territorial development. The results were validated in two ways: by sensitivity analysis in which two minimum and maximum scenarios were proposed concerning the result obtained and by validation using the receiver operating characteristic (ROC) curve method. The areas with high susceptibility to geo-hazards triggers are located in the southeastern part of the region, in the proximity of the hydrographic network. Flood risk is the hazard with the highest recurrence. Localities with high suitability for spatial development have a central-western distribution. According to the applied model, sites for each locality included in the study area can be identified. The high and very high suitability classes account for 54% of the total area, while the unsuitable classes represent 15% of the area. However, the vulnerability of the area and the need for the study are generated by 35% of the settlements being located in areas with high susceptibility.

Oral health status and related behavior in adults from North-Eastern region of Romania

Oral health status and related behavior in adults from North-Eastern region of Romania

Romanian early adolescents’ perceptions of parental migration and the associated relational impact: a qualitative analysis

ABSTRACT Previous literature has emphasised the complexities of early children’s perceptions of parental migration based on socio-cultural factors and the associated relational impact due to separation. Until recently, research on transnational families positioned children left behind in the country of origin as passive actors of parental migration, and focused less on children’s relational voice or agency. The present study addressed this gap by qualitatively exploring Romanian early adolescents’ evaluations of their parental separation and parent–child relationship within the context of parental international migration for labour. Further, the current study also assessed how early adolescents navigated these physically distanced relationships. In-depth interviews were conducted in 2017 with 121 participants (62 boys and 59 girls) aged between 10 and 14 years old (M = 12.66, SD = 1.41) from urban public schools from the Northeastern region of Romania. Thematic analysis indicated that while most participants evaluated parental international migration negatively, the majority of participants characterised aspects of their relationships with their migrant parent(s) positively. Further, participants noted that their migrant parents’ emotional and developmental support were key factors for maintaining positive relationships. Findings suggest the importance of exploring children’s perspectives regarding parental migration and the parent–child relationships when the effects of transnational migration are investigated.

Characteristics and Trends of COVID-19 Infection in a Tertiary Hospital in Romania: A Retrospective Study.

(1) Background: The outbreak of the COVID-19 pandemic represented a real challenge for all of humanity. Characterized by a complex spectrum of signs and symptoms, by various severity degrees, the disease spread rapidly around the world. After more than two and half years since the beginning of COVID-19 pandemic, in the context of a paradoxical, enigmatic, and relentless COVID-19, the objective of the current study was to evaluate the characteristics and evolution of patients with SARS-CoV-2 infection, hospitalized in "St. Parascheva" Clinical Hospital of Infectious Diseases (Iasi, Romania). (2) Methods: This is a retrospective study that used the medical database recorded between July and November 2021 in order to highlight the characteristics of SARS-CoV-2 infection in patients from the northeastern region of Romania. (3) Results: We enrolled in the study a total of 1732 SARS-CoV-2 infected patients, mean age 67 ± 3.4 years, the female gender predominating (987 cases; 56.98%) as well as patients from the urban environment (982 patients; 56.69%). Moderate form of the disease predominated (814 cases; 47%), pulmonary imaging changes were found in 1042 (60.16%) cases, and 1242 (71.71%) patients had at least one underlying disease. After a median length of hospitalization of 9.5 days, 1359 (78.46%) patients were discharged cured, 48 (2.77%) were transferred to other services by decompensating the associated pathologies, 302 (17.43%) patients needed extensive support in the intensive care unit and there were 325 (18.76%) deaths. (4) Conclusions: The epidemiological characteristics of SARS-CoV-2 infection recorded in our study were mostly the same as characteristics of COVID-19 from all over the world.

Anatomical study of circle of Willis on fresh autopsied brains. A study of a Romanian population.

Because the circle of Willis (CoW) supplies blood to the brain in case of occlusion of one of the cerebral arteries, identification of any change in its classical shape could be useful in the assessment of cerebrovascular morbidity. The purpose of our research was to study the anatomical variants of CoW identified on fresh brains obtained at the clinical autopsies of adult deceased patients belonging to a specific population (Northeastern region of Romania), as no data are available for Romania population up to date. The study group included consecutive patients who died in Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iaşi, Romania, due to medical causes between January 1, 2014 and June 30, 2016, to whom a clinical autopsy was performed. From a total of 96 circles of Willis, 29.17% presented an atypical morphology. We identified eight types of anatomical variants, which affected simultaneously both the posterior and the anterior parts of CoW in 46.42% of cases. The most frequent anatomical variants were hypoplasia (20.91%), followed by the absence of an artery (3.06%), and partially fetal type artery (2.04%). 67.86% of atypical CoW exhibited more than one anatomical variant of an artery in one circle. We identified nine of the 23 morphological patterns that were published to date, and also nine new types. Our research proved that in the population living in the Northeastern part of Romania the anatomical variations of circles of Willis are very polymorphic, with particular morphological aspects.

Determinants of Entrepreneurial Intentions of Youth: The Role of Access to Finance

This study aims to highlight the role of access to finance as one of the determinants on the decision to enter into entrepreneurship of students regarded as potential entrepreneurs. For achieving our main objective, we created a questionnaire. As a method of analysis, we run the least square logistic regression, with entrepreneurial intentions as a dependent variable and knowledge, education and availability of financial resources as predictors. We also included gender, university and locality as control variables. The sample is formed of 181 students from two universities from the North-Eastern region of Romania. The results reveal that access to finance is a significant determinant of the decision to enter into entreprenenruship for young people. Moreover, we show that the relation between access to finance and entrepreneurial intentions changes according to gender, university and locality of origin. Female students’ entrepreneurial intentions are influenced by the availability of bank loans and personal savings, while in case of male students - only by the availability of funds coming from family and friends. The funds coming from family and friends also determine students' entrepreneurial intentions coming from rural or urban areas. Entrepreneurial intentions are negatively related to education for male students and those coming from an economic profile university, and positively related to business knowledge only for students from rural areas. The results obtained could be important for financial resources providers (because they offer insight into how easy access to finance stimulates the entrepreneurial intentions of youth), for education providers (who can adapt their training programs and extracurricular activities to strengthen entrepreneurial intentions), and for decision makers (which may adopt appropriate policies to stimulate the economic development of an area).

The pregnancy rate among Romanian adolescents: an eleven years (2009--2020) observational, retrospective study from a single center.

It has been recently documented that Romania has the highest prevalence of adolescent pregnancy in Europe. Therefore, the present study aims to offer a conclusive view of the current situation by assessing a series of parameters in the last 11 years. Throughout the present manuscript, we showed that 1788 pregnancies occurred in the last 11 years in just one center from the northeastern region of Romania. The Kolmogorov-Smirnov test (p < 0.05) performed suggests that gestational age does not follow a normal distribution; an interval during which 899 (50.27%) male and 889 (49.72%) female babies were born. There were a total of 1383 (86.00%) deliveries at full-term and 225 (13.99%) were under 37 weeks. Of 1788 teenage girls, 1467 (82.04%) were from the rural area, whereas 321 (17.95%) from the urban area. Fortunately, one common feature that we observed was that starting from 2017 there was a significant reduction within the last 2 studied parameters, the situation being much more fluctuating until 2014.

A COMPARATIVE STUDY OF THE BEHAVIOUR OF ANTIRRHINUM MAJUS SPECIES CULTIVATED IN FIELDS AND IN VERTICAL SYSTEMS FOR GREEN FAÇADES UNDER THE CLIMATE CONDITIONS IN THE NORTH-EASTERN REGION OF ROMANIA

A highly popular and well-known flowering species for the unmistakable shape of its velvety and beautifully coloured flowers, Antirrhinum majus is often used in garden decor due to its long flowering period, ease of cultivation and low maintenance during the growing season. This study aims to investigate the behaviour of a dwarf variety of the Antirrhinum majus species grown in both vertical systems for green façades and also in a control field under the climate conditions in the north-eastern region of Romania. The façades of the vertical structure were been oriented towards a cardinal point, each of them having four equal layers arranged on height. The study found that this dwarf variety adapts very well to vertical systems, maintaining its ornamental features for a long time. During the experiment, observations included the diameter, height and number of flowers per plant in the control variant and on each side of the experimental structure. The highest values in July and August for plant diameter, plant height and the number of flowers were shown for the western facade and the lowest for the control variant. Instead, the control variant in September held the first position showing the highest means for all three monitored parameters and the lowest were for the southern orientation.

Anxiety and Frustration during the Covid-19 Pandemic

The lockdown and quarantine period set by authorities around the world in order to prevent the spread of the SARS-COV-2 virus has had a significant impact on the mental health of people around the world. The present research, carried out by qualitative methods, aimed at identifying the sources, but also the ways of expressing anxiety, frustration and anguish due to the Covid-19 pandemic and the measures to prevent the spread of the virus. The research was carried out on subjects of Romanian nationality, especially from the North Eastern Region of Romania. The main results of the research are: an extension of the medicalization of social life, the awareness of one's own finitude and the experience of helplessness, as sources of anxiety and frustration, and an accentuated social response to the risk society, manifested as a revolt against the authorities and the need to humanize every day life.

Anemia in Crohn's Disease-The Unseen Face of Inflammatory Bowel Disease.

Background and Objectives: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity. Our aim was to estimate the impact of anemia on QoL in patients with Crohn’s disease. Material and Methods. We made a prospective study on 134 patients with Crohn’s disease (CD) in a Romanian tertiary center. The CD diagnosis was established by colonoscopy and histopathological examination. In particular cases, additional examinations were required (small bowel capsule endoscopy, computed tomography enterography, and magnetic resonance enterography). Anemia was defined according to the World Health Organization’s definition, the activity of the disease was assessed by Crohn’s disease activity index (CDAI) score, and the QoL was evaluated by Inflammatory Bowel Disease Questionnaire 32 (IBDQ 32). Results: 44.8% patient had anemia, statistically related to the activity of the disease and corticoids use. We found a strong association between QoL and disease activity on all four sub-scores: patients with more severe activity had a significantly lower IBDQ (260.38 ± 116.96 vs. 163.85 ± 87.20, p = 0.001) and the presence of anemia (127.03 vs. 148.38, p = 0.001). In multiple regression analyses, both disease activity and anemia had an impact on the QoL. Conclusions: Anemia has high prevalence in the CD in northeastern region of Romania. Anemia was more common in female patients, in patients undergoing corticosteroid treatment, and in those with active disease. Both anemia and disease activity had a strong negative and independent impact on QoL.

Psoriasis—A Cancer Risk Factor?

Psoriasis is not considered a strictly skin condition, but a complex disease with multisystem involvement due to the frequent associated comorbidities. We conducted a retrospective database study of 10,986 patients admitted in the interval January 2008–January 2019 to the Dermatology Clinic of the Iasi County “St. Spiridon” Emergency Hospital. Of the 10,986 patients admitted, 1288 were diagnosed with psoriasis. The association of malignancies was found in 40 of the psoriasis group cases and 399 of the control group cases that included various dermatological conditions. The calculation of Odds Ratios allowed us to determine if the patients with psoriasis could be at risk for certain malignancies. Thus, an association was suggested between psoriasis and central nervous system (CNS), upper aerodigestive tract cancer, endocrine cancer, bladder cancer, lung cancer, prostate cancer, breast cancer, or colorectal cancer. It is the first study of its kind in the northeastern region of Romania and can be the starting point for future long-term prospective cohort studies that will allow a more accurate data collection and a better understanding of the psoriasis–cancer relationship.