Institutul National de Sanatate Publica

Interview with Adrian Miulescu, General Manager, INRMFB (National Institute of Recovery, Physical Medicine and Balneoclimatology)

Globally, Chronic Obstructive Pulmonary Disease is the third leadingcause of death and the seventh leading cause of disability, particularlyaffecting people in economically less developed countries, but trends inmorbidity are increasing everywhere, thus requiring more effective measuresto maintain optimal public health and reduce costs for administeredtreatments.

The promotion of medical services is regulated by national and internationallegislation that protects patients' rights and ensures an ethical standard inadvertising, this is a sensitive process that must comply with strict ethicalstandards and regulations. In the current context in which digitalization andcompetitiveness in the healthcare field require the adoption of effective methods ofattracting and retaining patients in the online and offline environment and giventhe direct impact on patients' health, any marketing and communication strategymust be transparent, fair and provide truthful information.

Background: Symptomatic bradyarrhythmias in dogs can lead to sever hemodynamical compromise due to impaired oxygen and nutrients delivery and even sudden cardiac death. In cases refractory to medical therapy the heart rate and therefore the cardiac output are maintained in physiological ranges using artificial external, internal and temporary (emergency situations) or internal and permanent cardiac pacing. Methods: This case report documents the implantation of a permanent transvenous Pacemaker using active fixation, for the first time in Romania in a 8 years old canine Dogue de Bordeaux with a suspicion (on surface electrocardiography) of Persistent Atrial Standstill. The diagnostic in this atrial muscular dystrophy requires differentiation from Atrial Fibrillation with Third Degree Atrioventricular Block using Cardiac Mapping, but in emergency situations or progressive Congestive Heart Failure the decision to implant the pacemaker should be based on the hemodynamical effects of the dysrhythmia and the definitive diagnostic should be made during the implantation of the device. Results: We succesfully implanted in this case a transvenous ventricular Solia S60 lead at the level of the 1/2 distance between the mid-septal and right ventricular apex that was connected to the subcutaneousely placed Pulse Generator (Enitra 6 SR). The survival after the procedure was 202 days (6 months and 18 days) and the patient's death was not related to a cardiac cause. The necropsy showed that the active fixation in this case was preserved and there were not identified any local rejections of the lead or at the site of the pulse generator. Conclusions: The outcome of the patient was positive regarding the described cardiac function in this case and the clinical signs went into remission shortly after the pacing.

It describes the 60-year history of the Institute of Applied Physics of the State University of Moldova and its main milestones: formation of the basic laboratories and production sectors, pilot production, and launching the journal „Elektronnaya obrabotka materialov” (Electronic Processing of Materials), consolidation of the scientific potential, training of highly qualified personnel, organization of conferences, effective cooperation, participation in national and international projects, scientific schools, development of activity ensuring a closed cycle - from basic research to applied research, to widely used technologies and technical means, main aspects of optimizing the structure, updating the research theme, development of innovative activities. It is stressed that the Institute of Applied Physics, with its traditions, experience and aspirations, has been and remains open to those who wish to pursue their doctoral and postdoctoral studies or to collaborate with its well-coordinated team.

Remote monitoring and artificial intelligence will become common and intertwined in anesthesiology by 2050. In the intraoperative period, technology will lead to the development of integrated monitoring systems that will integrate multiple data streams and allow anesthesiologists to track patients more effectively. This will free up anesthesiologists to focus on more complex tasks, such as managing risk and making value-based decisions. This will also enable the continued integration of remote monitoring and control towers having profound effects on coverage and practice models. In the PACU and ICU, the technology will lead to the development of early warning systems that can identify patients who are at risk of complications, enabling early interventions and more proactive care. The integration of augmented reality will allow for better integration of diverse types of data and better decision-making. Postoperatively, the proliferation of wearable devices that can monitor patient vital signs and track their progress will allow patients to be discharged from the hospital sooner and receive care at home. This will require increased use of telemedicine, which will allow patients to consult with doctors remotely. All of these advances will require changes to legal and regulatory frameworks that will enable new workflows that are different from those familiar to today's providers.

The generation and disposal of medical waste is an ongoing issue for medical facilities. Medical institutions, including hospitals, clinics, and facilities for patient diagnosis and treatment, produce highly hazardous waste for human. The actual pilot study used the questionnaire, based on the World Health Organization form, translated into Romanian where a number of pertinent questions were chosen. The form has been tested in 21 health facilities at the Republican and municipal levels. Tests were conducted online, the average number of beds in medical institutions being – 142.1±127.3 [M±SD]. The average number of employers in medical facilities was 268±173.9 [M±SD]. Following questionnaire testing and analysis of responses, three questions and 15 response options were excluded, 31 questions were amended or adjusted, and three new questions were added. Following the pilot study, it was noted that most of the questions met the criteria submitted for the form: specificity, clarity, simplicity of wording, veracity and reasoning. Additionally, a number of issues have been identified that require a complex and immediate approach.

<strong>Objectives.</strong> Nanomaterials, present in a wide range of products, have become an integral part of our everyday life. The purpose of this paper is to elucidate the main aspects of the applicability and impact of nanomaterials from the perspective of human health. <strong>Materials and methods. </strong>A synthesis of scientific publications, including chapters from specialist books, practical guides, methodical recommendations, on the diversity of nanomaterials and the possible impact on human health, using Pubmed, Pubchem, Google Scholar, Medline databases, was performed. Data from the WHO, CDC website was used. <strong>Results.</strong> Nanotechnology has gained great public interest due to the needs and applications of nanomaterials in almost every field of human activity (biotechnology, agriculture, automotive industry, construction, energy, medicine, electronics, textiles, cosmetics, information technologies), thus, unintentional and/or intentional exposure may occur, which may result in a greater risk to human health. <strong>Conclusions.</strong> Large-scale management of nanomaterials and processes opens up creative possibilities, and the benefits provided will have a substantial impact on all industries, science, agriculture, medicine, etc. Understanding of the effects of human exposure to nanomaterials is very limited, therefore multi-faceted exposure to nanomaterials is a multidisciplinary concern.

From the Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Accepted for publication July 11, 2022. Funding: None. The author declares no conflicts of interest. Reprints will not be available from the author. Address correspondence to W. Alan C. Mutch, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba (Bannatyne campus), Harry Medovy House, Second Floor, 671 William Ave, Winnipeg, MB R3E 0Z2, Canada. Address e-mail to [email protected].