Fracture treatment has experienced a fascinating evolution in the last years. The aim of this cha... more Fracture treatment has experienced a fascinating evolution in the last years. The aim of this chapter is to reveal some clinical and biomechanical studies regarding innovative implants. After a short introduction (1), we intend to present our results regarding (2) dynamic condylar screw versus condylar blade plate in complex supracondylar femoral fractures; (3) biomechanical analysis of four types of implants in humeral fractures; (4) clinical and experimental studies for optimal stabilization of trochanteric fractures: the gliding nail; (5) intramedullary XS nail for pilon and ankle fractures: design, biomechanics, and clinical results; (6) the XS nail for the treatment of patella and olecranon fractures; and (7) plates with polyaxial stability for fractures of distal radius and proximal humerus. In conclusion, the authors highlight the advantages of these innovative implants in difficult trauma cases.
Type A haemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency as p... more Type A haemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency as part of the rare, life-threatening and at-risk group of diseases that has been attributed over time a life-saving substitution treatment providing to patients diagnosed with this pathology a hope for life and quality of life similar to that of healthy population. However, substitution treatment is very expensive so that nowadays globally most patients cannot benefit from proper healthcare. The quality of healthcare is dependent on the socioeconomic level of each country, being decisively influenced by the power of the National Hemophilia Organizations to generate solidarity and support of decision-makers of each country. One of the bleeding manifestations specific to haemophilia is haemarthrosis. Each haemorrhagic episode causes locally a disorder that predisposes to relapse, with the onset of the main chronic complication of this condition, haemophilic arthropathy. It has a slow evolution throughout the life of the patient and generates in time severe sequelae (ankyloses) that require total arthroplasty. Effective hemostasis is the essential element for performing this type of orthopaedic surgery, due to bleeding risk that is of vital nature, in this category of patients. In this sense, this study aims to underline the efficacy of Moroctocog alfa in the management of haemostasis in haemophiliac patients with total endoprosthesis indication, aimed to reduce joint pain and improve locomotor function.
DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2019
Depression is the most common psychiatric disorder in the elderly, as well as one of the most com... more Depression is the most common psychiatric disorder in the elderly, as well as one of the most common comorbidities in patients with hip fracture. Although many authors have confirmed that clinically recognized depressive symptomatology after hip fracture has a negative impact on functional outcomes and mortality, the role of depressive symptomatology evaluated at the time of admission remains insufficiently investigated. Depression can be assessed using the Geriatric Depression Scale. Predictor measurements of rehabilitation results that can interact with depression can be obtained. Linear multiple regression modeling can be used to evaluate the relationship between depression and functional outcome. The identified factors associated with the postoperative 1 and 2 year follow-up of a hip fracture should be incorporated into clinical strategies and postoperative nursing to provide muscle rehabilitation and good functional outcomes. In addition, the health care plan must ensure, before discharge, that the community in which older adults live provides nutritional education, cognitive screening and psychological support. Depression is a common disorder among orthopedic patients. A previous psychiatric diagnosis predisposes patients to depression following a trauma. The socioeconomic status is also a predictive factor for increasing depression scores at 9 months after discharge. Patients with a greater sense of support from friends and family have an inverse correlation with depression. Reestablishing the quality of life the patient had before the fracture also seems to have a protective effect against depression. The severity of the trauma does not seem to affect the scores for the evaluation of depression. Psychiatric counseling can avoid associated psychiatric comorbidities in trauma patients. High
Dementia and hip fractures are two crucial problems in the elderly and the associations of these ... more Dementia and hip fractures are two crucial problems in the elderly and the associations of these pathologies increase substantial morbidity and mortality. 178 patients with dementia (average age 81.5 years) were operated with an uncemented bipolar prosthesis for a displaced femoral neck
In medical practice, a particularly important therapeutic problem is the patient with traumatic i... more In medical practice, a particularly important therapeutic problem is the patient with traumatic injuries developing ethanol withdrawal during hospitalization. The management of such patients requires both a comprehensive approach in terms of therapy and a very delicate one regarding issues of medical ethics and social implications and costs. More medical schools, among which the ones in France, the US, the UK, etc., opt for the administration of alcoholic solutions, perfusable ones included, for preventing withdrawal symptoms. We consider that currently the relevant Romanian protocols are inappropriate as they ignore the fact that an addiction can be cured only if the patient is willing to and, even if this is the case, alcohol dependence is unlikely to be cured. Therefore, we believe that the preventive administration of certain alcoholic solutions in hospital would be beneficial both to the patient’s evolution and to the prevention of the social implications of treating the alcohol withdrawal syndrome (AWS) in a trauma center or intensive care unit.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction. The combined presentation of dementia and hip fracture in the elderly is emerging a... more Introduction. The combined presentation of dementia and hip fracture in the elderly is emerging as a significant health issue worldwide. An individual with dementia is up to 3 times more likely than a cognitively intact older adult to sustain a hip fracture. Objectives. 10 participants were recruited, 7 were women and 3 were cognitively impaired. Mean age was 80 years. All hip fractures are treated with surgery. This study analyzes recovery, incidence of delirium and 30-day mortality, after hip surgery. Results and discussion. Patients with dementia make poor functional recoveries after hip fracture as compared to nondemented patients. Individuals with dementia use rehabilitation less after hip fracture surgery. Early operative intervention is important to patients because it results in less pain, which in turn leads to lower incidence of delirium. Patients with dementia experience higher rates of all-round morbidity and mortality following hip fracture. Conclusion. The goal of acute-care hospital treatment of patients with hip fractures including those with dementia is to achieve the following outcomes: short time to surgery, few or no complications, control of pain, and early mobilization for restoration of function and gait. Following a hip fracture, patients with dementia are at higher risk of mortality and functional decline than those who are cognitively intact.
Operational risk appears to be a sword of Damocles in the world of insurance. Despite the advance... more Operational risk appears to be a sword of Damocles in the world of insurance. Despite the advanced studies that have been carried out in the field, regardless of whether the company is using an internal model or a standard model, no solution proved to be suitable for the whole industry at the European level prior to the full implementation of Solvency 2 (i.e. January 1, 2016). This paper aims to cover specific aspects of managing operational risk developed in other industries (where operational risks have sometimes lethal consequences, compared to only financial consequences in insurance) that could be envisaged for an effective and efficient outcome.
2021 International Conference on e-Health and Bioengineering (EHB), Nov 18, 2021
We report a successful case of a patient with type A haemophilia, with advanced valgus knee osteo... more We report a successful case of a patient with type A haemophilia, with advanced valgus knee osteoarthritis. The patient underwent surgery with metaphyseal cemented modular rotating hinge prosthesis type RT-PLUS Modular® and Moroctocog Alpha substitution treatment for effective hemostasis.
The domestic economic policy -from macroeconomic influences to strengthening the competitive equi... more The domestic economic policy -from macroeconomic influences to strengthening the competitive equity Ioan Cuzman, Daniel Manaţe, Pavel Fărcaş / 20 The performance of romanian open-end funds and the crisis context Carmen Corduneanu, Daniela Ţurcaş / 26 Financial crime and the securization of banking circuits in order to prevent and fight against money laundering Ion Stancu, Daniel Rece, Filip Iorgulescu / 34 Theoretical and Applied Economics. Supplement 6 6 Estimating taxation rate based on Blanchard's approach Andreea Stoian / 130 Local budget process and local economic development Cristinel Ichim / 137 Financing methods for the Romanian local public administration authorities Emilian Constantin Miricescu / 144 Some remarks on the "evaluation problem" in cost-benefit analytics Mihaela Iacob, Georgiana Camelia Creţan / 154 Effectiveness of cohesion policy in reducing regional disparities. divergence between national and regional convergence Meral Kagitci / 161 The Romanian municipal bonds -a challenge for local public finance and for investors Carmen Maria Lăcătuş, Florin Văduva / 166 The impact of the global crisis on public expenditure in education Irina-Florentina Băjan, Alina Creţu, Elena Peptan / 174 The local development and the decentralization process in the context of the financial crisis Maria Letiţia Brătulescu / 179 Tendencies in funding european higher education Georgiana Camelia Creţan, Mihaela Iacob / 187 Difficulties in the quantification of human capital Irina Zgreabăn, Rodica Gherghina, Anca Mirela Postole / 194 From the transition difficulties to the challenges of the economic and financial crisis: state aid in central Europe Nicolae Băcilă / 201 Romania's fiscal policy during the current crisis: present and future prospects
Some disadvantages of traditional metallic implants used in orthopedics and traumatology prompted... more Some disadvantages of traditional metallic implants used in orthopedics and traumatology prompted the development of bioresorbable polymer devices.The aim of this experimental study is to emphasize the characteristics of INION ® resorbable implants (regarding design and polymers compositions), as well as to evaluate the results when using these innovative implants in two trauma cases. The polymers used in manufacturing INION ® devices (Trimethylene Carbonate/TMC; L-Polylactic acid/LPLA; D,L Polylactic acid/ DLPLA; Polyglycolic acid/PGA) degrade in alpha-hydroxy acids, gradually losing their hardness in 18-36 weeks with a complete bioresorption of 2-4 years. The clinical cases demonstrated the advantages of INION ® plates (adapted shape, low profile, polyaxial screws, acceptable strength) or pins (allowing the aligmment and fixation of fracture, no migration). Among our patients, we found excellent results concerning the maintaining of primary reduced fracture, active range of motion, minimal pain with improving everyday comfort, no tissue or implant complications. Bioresorbable fracture fixation INION ® devices are a viable alternative to traditional metallic implants, offering same significant advantages over them: the avoidance of long-term interference with gliding structures, keeping their strength long enough to support bone healing, no need to remove the implants, less pain, radiolucency, elimination of stress shielding and a lower risk of complications.
Hemophilia is a hereditary coagulopathy that is largely in the attention of developing countries,... more Hemophilia is a hereditary coagulopathy that is largely in the attention of developing countries, not because of its low incidence, but because of the high costs involved in the treatment of the disease and its disabling consequences of the disease, if treated inappropriately. The concentrates of coagulation factors currently available for the substitution treatment of hemophilic patients have undergone additional viral purification and inactivation techniques, in order to achieve a higher infectious safety, an aspect that also implies an increase in treatment costs for these patients. Currently, the major morbidity of patients with hemophilia is represented by the disabling articular pathology, secondary to repetitive bleeding episodes developed in the articular space. Although it has been proved that the prophylactic administration of coagulation factors helps to prevent joint disease in the case of patients that were not subject to prophylaxis, the repeated bleeding in the joints induces synovitis, which is irreversible and may progress despite subsequent prophylaxis. Under these conditions, total joint arthroplasty remains the only solution to reduce both, pain and subsequent bleeding episodes of hemophilic arthropathy. Effective hemostasis is a basic condition for successful interventions in hemophilic patients. In this regard, this paper aims to highlight the effectiveness of Nonacog Alpha, a product that contains recombinant factor IX, in the management of hemostasis, in the case of a patient with type B hemophilia, with indication of total endoprosthesis of the left hip.
The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia n... more The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia no tourniquet (WALANT) technique in hand surgery, to present our results and to encourage its use on Romania and all over the world. The study group consisted of 120 patients in which local anesthesia with 1% lidocaine and 1: 100,000 epinephrine solution was used. The conditions requiring surgery were Dupuytren disease (DD) stages II and III affecting one or two digital rays, carpal tunnel syndrome (CTS), trigger finger (TF), rupture of the flexor pollicis longus (FPL) tendon. The amount of anesthetic used, onset time, intraoperative bleeding, surgeon's comfort during surgery, patient's comfort, operative time, the immediate postoperative complications and length of hospital stay were evaluated, correlations between these parameters being made with the help of SPSS 20.0 software using regressions (ANOVA), and taking into account Pearson correlation coefficients with statistical significance, alpha at most .05 and CI 95%. In the group of 120 operated patients (58 men-M and 62 female-F) (M/F ratio = 0.93), no cases of digital necrosis or other vascular complications were recorded. Also, the absence of tourniquets did not result in intraoperative bleeding causing discomfort to the surgeon. The amount of anesthetic varied, being less than that recommended in the literature in approximately 40% of the cases. In all cases, patient comfort and satisfaction were highest, and length of hospital stay was several hours. Phentolamine, an antidote used to reverse the effects of epinephrine, was not used in any case. The correlation coefficient between the amount of anesthetic and waiting time = 0.3372 (p = 0.0001)-positive, direct, moderate, and statistically significant correlation. The correlation coefficient between the amount of anesthetic and length of hospital stay = 0.2700 (p = 0.002)-positive, direct, weak and statistically significant correlation. Correlation coefficient between age and length of hospital stay = 0.1361 (p = 0.1380)-positive, direct, weak correlation, but statistically insignificant. WALANT technique is safe and has many advantages: no need it is not necessary to use the tourniquet and intravenous sedation, surgeon and patient comfort is maximum, there is no risk of finger necrosis, intraoperative collaboration and last but not the least, hospital stay is short and costs are minimal.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction. Hip fractures are more common especially in women, in the elderly, due to osteoporo... more Introduction. Hip fractures are more common especially in women, in the elderly, due to osteoporosis. Almost half of all people who suffer hip fractures also have dementia. Patients with dementia recover slower and they are more prone to complications. Objectives. We present 6 female patients (65 years and older) with dementia who received a different therapy: 3 surgical and the other 3 who were unfit for surgeries were treated conservatively. The main reason for non-operative intervention was the latter stages of dementia, consistent with an anticipated rapid deterioration or death. Results and discussion. In conservative treatment group, no female could walk with assist or independently compared with surgical grop where 1 female could walk with assist. Conservative group had less desire for active treatments and rehabilitation. At long-term quality of life in the surgical group was not higher than reported following conservative care group. Conclusion. There is insufficient evidence to draw conclusions about how effective is the surgical treatment or non-surgical care for people with dementia and hip fracture. Increased attention should be focused on efforts to enhance comfort in this patient population.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction Fractures in old age is a major health problem with considerable disability and mort... more Introduction Fractures in old age is a major health problem with considerable disability and mortality. Antipsychotic drugs (APs) have been associated with falls and fractures in elderly individuals. Methods The study performed was a retrospective analysis with 97 participants. Subjects were everyone over the age of 65 with fractures radiologically confirmed, hospitalized in Department of Orthopaedics and Traumatology "Sf. Ap. Andrei" Galaţi, România, in May 2017. The objective was to evaluate the association between APs and the risk of fractures in elderly persons. Results and discussion 16 participants with confirmed fracture (16.50%) was associated with exposure to psychotropic medications. Those who took selective serotonin reuptake inhibitors (SSRIs), in particular, are linked to greater susceptibility to bone fractures: 10 out of 16 participants. Conclusion The mechanism leading to this increased risk is unclear. Clinical studies examining causality or mechanisms of the observed association between antipsychotic drug use and excess risk of fractures are needed. Confounding by indication, other drugs used or comorbidity cannot be excluded, this association is relevant for clinical practice because fractures and antipsychotic drug use are prevalent in vulnerable older individuals.
Much more specialists are nowadays aligning themselves on the view according to which the prevale... more Much more specialists are nowadays aligning themselves on the view according to which the prevalence of cardiovascular disease will reach epidemic levels in the near future due to the increase of hypertension, diabetes and obesity. Most epidemiological studies indicate that we are confronted with a multiplication of risk factors, with an emphasis on their genetic conditioning as well as an acceleration of the effects generated by non-genetic factors. According to WHO recommendations, the appropriate methods of reducing the cardiovascular risk are those that combine health policies with efficient education measures. Long-term results of these measures aim to decrease the incidence of complications and associated costs with their treatment at the same time with increasing the quality of life. Approximately 50% of deaths from heart disease could be prevented through sustained action on the main cause-hypertension-and by treating risk factors, primarily hyperlipidemia and elevated body weight. Atherosclerotic disease requires a rigorous approach because identifying predisposing risk factors with proven implications in the initiation and progression of this disease, as well as modulation of those with protective role, can have a significant impact in finding an appropriate treatment in order to improve cardiovascular diseases and their consequences.
Proceedings of the ... International Conference on Business Excellence, Jul 1, 2017
This paper aims at covering and describing the shortcomings of various models used to quantify an... more This paper aims at covering and describing the shortcomings of various models used to quantify and model the operational risk within insurance industry with a particular focus on Romanian specific regulation: Norm 6/2015 concerning the operational risk issued by IT systems. While most of the local insurers are focusing on implementing the standard model to compute the Operational Risk solvency capital required, the local regulator has issued a local norm that requires to identify and assess the IT based operational risks from an ISO 27001 perspective. The challenges raised by the correlations assumed in the Standard model are substantially increased by this new regulation that requires only the identification and quantification of the IT operational risks. The solvency capital requirement stipulated by the implementation of Solvency II doesn't recommend a model or formula on how to integrate the newly identified risks in the Operational Risk capital requirements. In this context we are going to assess the academic and practitioner's understanding in what concerns: The Frequency-Severity approach, Bayesian estimation techniques, Scenario Analysis and Risk Accounting based on risk units, and how they could support the modelling of operational risk that are IT based. Developing an internal model only for the operational risk capital requirement proved to be, so far, costly and not necessarily beneficial for the local insurers. As the IT component will play a key role in the future of the insurance industry, the result of this analysis will provide a specific approach in operational risk modelling that can be implemented in the context of Solvency II, in a particular situation when (internal or external) operational risk databases are scarce or not available.
Fracture treatment has experienced a fascinating evolution in the last years. The aim of this cha... more Fracture treatment has experienced a fascinating evolution in the last years. The aim of this chapter is to reveal some clinical and biomechanical studies regarding innovative implants. After a short introduction (1), we intend to present our results regarding (2) dynamic condylar screw versus condylar blade plate in complex supracondylar femoral fractures; (3) biomechanical analysis of four types of implants in humeral fractures; (4) clinical and experimental studies for optimal stabilization of trochanteric fractures: the gliding nail; (5) intramedullary XS nail for pilon and ankle fractures: design, biomechanics, and clinical results; (6) the XS nail for the treatment of patella and olecranon fractures; and (7) plates with polyaxial stability for fractures of distal radius and proximal humerus. In conclusion, the authors highlight the advantages of these innovative implants in difficult trauma cases.
Type A haemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency as p... more Type A haemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency as part of the rare, life-threatening and at-risk group of diseases that has been attributed over time a life-saving substitution treatment providing to patients diagnosed with this pathology a hope for life and quality of life similar to that of healthy population. However, substitution treatment is very expensive so that nowadays globally most patients cannot benefit from proper healthcare. The quality of healthcare is dependent on the socioeconomic level of each country, being decisively influenced by the power of the National Hemophilia Organizations to generate solidarity and support of decision-makers of each country. One of the bleeding manifestations specific to haemophilia is haemarthrosis. Each haemorrhagic episode causes locally a disorder that predisposes to relapse, with the onset of the main chronic complication of this condition, haemophilic arthropathy. It has a slow evolution throughout the life of the patient and generates in time severe sequelae (ankyloses) that require total arthroplasty. Effective hemostasis is the essential element for performing this type of orthopaedic surgery, due to bleeding risk that is of vital nature, in this category of patients. In this sense, this study aims to underline the efficacy of Moroctocog alfa in the management of haemostasis in haemophiliac patients with total endoprosthesis indication, aimed to reduce joint pain and improve locomotor function.
DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 2019
Depression is the most common psychiatric disorder in the elderly, as well as one of the most com... more Depression is the most common psychiatric disorder in the elderly, as well as one of the most common comorbidities in patients with hip fracture. Although many authors have confirmed that clinically recognized depressive symptomatology after hip fracture has a negative impact on functional outcomes and mortality, the role of depressive symptomatology evaluated at the time of admission remains insufficiently investigated. Depression can be assessed using the Geriatric Depression Scale. Predictor measurements of rehabilitation results that can interact with depression can be obtained. Linear multiple regression modeling can be used to evaluate the relationship between depression and functional outcome. The identified factors associated with the postoperative 1 and 2 year follow-up of a hip fracture should be incorporated into clinical strategies and postoperative nursing to provide muscle rehabilitation and good functional outcomes. In addition, the health care plan must ensure, before discharge, that the community in which older adults live provides nutritional education, cognitive screening and psychological support. Depression is a common disorder among orthopedic patients. A previous psychiatric diagnosis predisposes patients to depression following a trauma. The socioeconomic status is also a predictive factor for increasing depression scores at 9 months after discharge. Patients with a greater sense of support from friends and family have an inverse correlation with depression. Reestablishing the quality of life the patient had before the fracture also seems to have a protective effect against depression. The severity of the trauma does not seem to affect the scores for the evaluation of depression. Psychiatric counseling can avoid associated psychiatric comorbidities in trauma patients. High
Dementia and hip fractures are two crucial problems in the elderly and the associations of these ... more Dementia and hip fractures are two crucial problems in the elderly and the associations of these pathologies increase substantial morbidity and mortality. 178 patients with dementia (average age 81.5 years) were operated with an uncemented bipolar prosthesis for a displaced femoral neck
In medical practice, a particularly important therapeutic problem is the patient with traumatic i... more In medical practice, a particularly important therapeutic problem is the patient with traumatic injuries developing ethanol withdrawal during hospitalization. The management of such patients requires both a comprehensive approach in terms of therapy and a very delicate one regarding issues of medical ethics and social implications and costs. More medical schools, among which the ones in France, the US, the UK, etc., opt for the administration of alcoholic solutions, perfusable ones included, for preventing withdrawal symptoms. We consider that currently the relevant Romanian protocols are inappropriate as they ignore the fact that an addiction can be cured only if the patient is willing to and, even if this is the case, alcohol dependence is unlikely to be cured. Therefore, we believe that the preventive administration of certain alcoholic solutions in hospital would be beneficial both to the patient’s evolution and to the prevention of the social implications of treating the alcohol withdrawal syndrome (AWS) in a trauma center or intensive care unit.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction. The combined presentation of dementia and hip fracture in the elderly is emerging a... more Introduction. The combined presentation of dementia and hip fracture in the elderly is emerging as a significant health issue worldwide. An individual with dementia is up to 3 times more likely than a cognitively intact older adult to sustain a hip fracture. Objectives. 10 participants were recruited, 7 were women and 3 were cognitively impaired. Mean age was 80 years. All hip fractures are treated with surgery. This study analyzes recovery, incidence of delirium and 30-day mortality, after hip surgery. Results and discussion. Patients with dementia make poor functional recoveries after hip fracture as compared to nondemented patients. Individuals with dementia use rehabilitation less after hip fracture surgery. Early operative intervention is important to patients because it results in less pain, which in turn leads to lower incidence of delirium. Patients with dementia experience higher rates of all-round morbidity and mortality following hip fracture. Conclusion. The goal of acute-care hospital treatment of patients with hip fractures including those with dementia is to achieve the following outcomes: short time to surgery, few or no complications, control of pain, and early mobilization for restoration of function and gait. Following a hip fracture, patients with dementia are at higher risk of mortality and functional decline than those who are cognitively intact.
Operational risk appears to be a sword of Damocles in the world of insurance. Despite the advance... more Operational risk appears to be a sword of Damocles in the world of insurance. Despite the advanced studies that have been carried out in the field, regardless of whether the company is using an internal model or a standard model, no solution proved to be suitable for the whole industry at the European level prior to the full implementation of Solvency 2 (i.e. January 1, 2016). This paper aims to cover specific aspects of managing operational risk developed in other industries (where operational risks have sometimes lethal consequences, compared to only financial consequences in insurance) that could be envisaged for an effective and efficient outcome.
2021 International Conference on e-Health and Bioengineering (EHB), Nov 18, 2021
We report a successful case of a patient with type A haemophilia, with advanced valgus knee osteo... more We report a successful case of a patient with type A haemophilia, with advanced valgus knee osteoarthritis. The patient underwent surgery with metaphyseal cemented modular rotating hinge prosthesis type RT-PLUS Modular® and Moroctocog Alpha substitution treatment for effective hemostasis.
The domestic economic policy -from macroeconomic influences to strengthening the competitive equi... more The domestic economic policy -from macroeconomic influences to strengthening the competitive equity Ioan Cuzman, Daniel Manaţe, Pavel Fărcaş / 20 The performance of romanian open-end funds and the crisis context Carmen Corduneanu, Daniela Ţurcaş / 26 Financial crime and the securization of banking circuits in order to prevent and fight against money laundering Ion Stancu, Daniel Rece, Filip Iorgulescu / 34 Theoretical and Applied Economics. Supplement 6 6 Estimating taxation rate based on Blanchard's approach Andreea Stoian / 130 Local budget process and local economic development Cristinel Ichim / 137 Financing methods for the Romanian local public administration authorities Emilian Constantin Miricescu / 144 Some remarks on the "evaluation problem" in cost-benefit analytics Mihaela Iacob, Georgiana Camelia Creţan / 154 Effectiveness of cohesion policy in reducing regional disparities. divergence between national and regional convergence Meral Kagitci / 161 The Romanian municipal bonds -a challenge for local public finance and for investors Carmen Maria Lăcătuş, Florin Văduva / 166 The impact of the global crisis on public expenditure in education Irina-Florentina Băjan, Alina Creţu, Elena Peptan / 174 The local development and the decentralization process in the context of the financial crisis Maria Letiţia Brătulescu / 179 Tendencies in funding european higher education Georgiana Camelia Creţan, Mihaela Iacob / 187 Difficulties in the quantification of human capital Irina Zgreabăn, Rodica Gherghina, Anca Mirela Postole / 194 From the transition difficulties to the challenges of the economic and financial crisis: state aid in central Europe Nicolae Băcilă / 201 Romania's fiscal policy during the current crisis: present and future prospects
Some disadvantages of traditional metallic implants used in orthopedics and traumatology prompted... more Some disadvantages of traditional metallic implants used in orthopedics and traumatology prompted the development of bioresorbable polymer devices.The aim of this experimental study is to emphasize the characteristics of INION ® resorbable implants (regarding design and polymers compositions), as well as to evaluate the results when using these innovative implants in two trauma cases. The polymers used in manufacturing INION ® devices (Trimethylene Carbonate/TMC; L-Polylactic acid/LPLA; D,L Polylactic acid/ DLPLA; Polyglycolic acid/PGA) degrade in alpha-hydroxy acids, gradually losing their hardness in 18-36 weeks with a complete bioresorption of 2-4 years. The clinical cases demonstrated the advantages of INION ® plates (adapted shape, low profile, polyaxial screws, acceptable strength) or pins (allowing the aligmment and fixation of fracture, no migration). Among our patients, we found excellent results concerning the maintaining of primary reduced fracture, active range of motion, minimal pain with improving everyday comfort, no tissue or implant complications. Bioresorbable fracture fixation INION ® devices are a viable alternative to traditional metallic implants, offering same significant advantages over them: the avoidance of long-term interference with gliding structures, keeping their strength long enough to support bone healing, no need to remove the implants, less pain, radiolucency, elimination of stress shielding and a lower risk of complications.
Hemophilia is a hereditary coagulopathy that is largely in the attention of developing countries,... more Hemophilia is a hereditary coagulopathy that is largely in the attention of developing countries, not because of its low incidence, but because of the high costs involved in the treatment of the disease and its disabling consequences of the disease, if treated inappropriately. The concentrates of coagulation factors currently available for the substitution treatment of hemophilic patients have undergone additional viral purification and inactivation techniques, in order to achieve a higher infectious safety, an aspect that also implies an increase in treatment costs for these patients. Currently, the major morbidity of patients with hemophilia is represented by the disabling articular pathology, secondary to repetitive bleeding episodes developed in the articular space. Although it has been proved that the prophylactic administration of coagulation factors helps to prevent joint disease in the case of patients that were not subject to prophylaxis, the repeated bleeding in the joints induces synovitis, which is irreversible and may progress despite subsequent prophylaxis. Under these conditions, total joint arthroplasty remains the only solution to reduce both, pain and subsequent bleeding episodes of hemophilic arthropathy. Effective hemostasis is a basic condition for successful interventions in hemophilic patients. In this regard, this paper aims to highlight the effectiveness of Nonacog Alpha, a product that contains recombinant factor IX, in the management of hemostasis, in the case of a patient with type B hemophilia, with indication of total endoprosthesis of the left hip.
The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia n... more The aim of the study was to confirm the effectiveness and safety of wide awake local anesthesia no tourniquet (WALANT) technique in hand surgery, to present our results and to encourage its use on Romania and all over the world. The study group consisted of 120 patients in which local anesthesia with 1% lidocaine and 1: 100,000 epinephrine solution was used. The conditions requiring surgery were Dupuytren disease (DD) stages II and III affecting one or two digital rays, carpal tunnel syndrome (CTS), trigger finger (TF), rupture of the flexor pollicis longus (FPL) tendon. The amount of anesthetic used, onset time, intraoperative bleeding, surgeon's comfort during surgery, patient's comfort, operative time, the immediate postoperative complications and length of hospital stay were evaluated, correlations between these parameters being made with the help of SPSS 20.0 software using regressions (ANOVA), and taking into account Pearson correlation coefficients with statistical significance, alpha at most .05 and CI 95%. In the group of 120 operated patients (58 men-M and 62 female-F) (M/F ratio = 0.93), no cases of digital necrosis or other vascular complications were recorded. Also, the absence of tourniquets did not result in intraoperative bleeding causing discomfort to the surgeon. The amount of anesthetic varied, being less than that recommended in the literature in approximately 40% of the cases. In all cases, patient comfort and satisfaction were highest, and length of hospital stay was several hours. Phentolamine, an antidote used to reverse the effects of epinephrine, was not used in any case. The correlation coefficient between the amount of anesthetic and waiting time = 0.3372 (p = 0.0001)-positive, direct, moderate, and statistically significant correlation. The correlation coefficient between the amount of anesthetic and length of hospital stay = 0.2700 (p = 0.002)-positive, direct, weak and statistically significant correlation. Correlation coefficient between age and length of hospital stay = 0.1361 (p = 0.1380)-positive, direct, weak correlation, but statistically insignificant. WALANT technique is safe and has many advantages: no need it is not necessary to use the tourniquet and intravenous sedation, surgeon and patient comfort is maximum, there is no risk of finger necrosis, intraoperative collaboration and last but not the least, hospital stay is short and costs are minimal.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction. Hip fractures are more common especially in women, in the elderly, due to osteoporo... more Introduction. Hip fractures are more common especially in women, in the elderly, due to osteoporosis. Almost half of all people who suffer hip fractures also have dementia. Patients with dementia recover slower and they are more prone to complications. Objectives. We present 6 female patients (65 years and older) with dementia who received a different therapy: 3 surgical and the other 3 who were unfit for surgeries were treated conservatively. The main reason for non-operative intervention was the latter stages of dementia, consistent with an anticipated rapid deterioration or death. Results and discussion. In conservative treatment group, no female could walk with assist or independently compared with surgical grop where 1 female could walk with assist. Conservative group had less desire for active treatments and rehabilitation. At long-term quality of life in the surgical group was not higher than reported following conservative care group. Conclusion. There is insufficient evidence to draw conclusions about how effective is the surgical treatment or non-surgical care for people with dementia and hip fracture. Increased attention should be focused on efforts to enhance comfort in this patient population.
American journal of psychiatry and neuroscience, Oct 14, 2017
Introduction Fractures in old age is a major health problem with considerable disability and mort... more Introduction Fractures in old age is a major health problem with considerable disability and mortality. Antipsychotic drugs (APs) have been associated with falls and fractures in elderly individuals. Methods The study performed was a retrospective analysis with 97 participants. Subjects were everyone over the age of 65 with fractures radiologically confirmed, hospitalized in Department of Orthopaedics and Traumatology "Sf. Ap. Andrei" Galaţi, România, in May 2017. The objective was to evaluate the association between APs and the risk of fractures in elderly persons. Results and discussion 16 participants with confirmed fracture (16.50%) was associated with exposure to psychotropic medications. Those who took selective serotonin reuptake inhibitors (SSRIs), in particular, are linked to greater susceptibility to bone fractures: 10 out of 16 participants. Conclusion The mechanism leading to this increased risk is unclear. Clinical studies examining causality or mechanisms of the observed association between antipsychotic drug use and excess risk of fractures are needed. Confounding by indication, other drugs used or comorbidity cannot be excluded, this association is relevant for clinical practice because fractures and antipsychotic drug use are prevalent in vulnerable older individuals.
Much more specialists are nowadays aligning themselves on the view according to which the prevale... more Much more specialists are nowadays aligning themselves on the view according to which the prevalence of cardiovascular disease will reach epidemic levels in the near future due to the increase of hypertension, diabetes and obesity. Most epidemiological studies indicate that we are confronted with a multiplication of risk factors, with an emphasis on their genetic conditioning as well as an acceleration of the effects generated by non-genetic factors. According to WHO recommendations, the appropriate methods of reducing the cardiovascular risk are those that combine health policies with efficient education measures. Long-term results of these measures aim to decrease the incidence of complications and associated costs with their treatment at the same time with increasing the quality of life. Approximately 50% of deaths from heart disease could be prevented through sustained action on the main cause-hypertension-and by treating risk factors, primarily hyperlipidemia and elevated body weight. Atherosclerotic disease requires a rigorous approach because identifying predisposing risk factors with proven implications in the initiation and progression of this disease, as well as modulation of those with protective role, can have a significant impact in finding an appropriate treatment in order to improve cardiovascular diseases and their consequences.
Proceedings of the ... International Conference on Business Excellence, Jul 1, 2017
This paper aims at covering and describing the shortcomings of various models used to quantify an... more This paper aims at covering and describing the shortcomings of various models used to quantify and model the operational risk within insurance industry with a particular focus on Romanian specific regulation: Norm 6/2015 concerning the operational risk issued by IT systems. While most of the local insurers are focusing on implementing the standard model to compute the Operational Risk solvency capital required, the local regulator has issued a local norm that requires to identify and assess the IT based operational risks from an ISO 27001 perspective. The challenges raised by the correlations assumed in the Standard model are substantially increased by this new regulation that requires only the identification and quantification of the IT operational risks. The solvency capital requirement stipulated by the implementation of Solvency II doesn't recommend a model or formula on how to integrate the newly identified risks in the Operational Risk capital requirements. In this context we are going to assess the academic and practitioner's understanding in what concerns: The Frequency-Severity approach, Bayesian estimation techniques, Scenario Analysis and Risk Accounting based on risk units, and how they could support the modelling of operational risk that are IT based. Developing an internal model only for the operational risk capital requirement proved to be, so far, costly and not necessarily beneficial for the local insurers. As the IT component will play a key role in the future of the insurance industry, the result of this analysis will provide a specific approach in operational risk modelling that can be implemented in the context of Solvency II, in a particular situation when (internal or external) operational risk databases are scarce or not available.
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