BackgroundOngoing education of health professionals in rheumatology (HPR) is critical for high-qu... more BackgroundOngoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings.Methods and participantsWe developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed theChecklist for Reporting Results of Internet E-Surveysguideline.ResultsThe questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries we...
Objectives: Soft and hard tissue breakdown was histologically and radiologically assessed around ... more Objectives: Soft and hard tissue breakdown was histologically and radiologically assessed around implants with alternate, consecutively placed ligatures on the same edentulous dog hemimandible. The influence of ligatured implants (LI) on adjacent non-ligatured implants (NLI, as a possible naturally induced peri-implantitis) was also evaluated. Material and Methods: Three months after tooth extraction, five dental implants were placed in the dog hemimandible. Two months after abutment placement, ligatures were placed subsequently two months apart on alternate implants, while both intermediate implants were left without ligatures. Ligatures were kept in place during the entire experiment, and no plaque control measures were taken. Eleven months post-implantation, the animal was sacrificed. Undecalcified ground sections were cut, stained with Masson Goldner and MOVAT Pentachrome and evaluated by light microscopy. Soft and hard tissue loss was assessed using histomorphometric and CBCT p...
International Journal of Environmental Research and Public Health
The use of tobacco products is a major global public health issue, as it is the leading cause of ... more The use of tobacco products is a major global public health issue, as it is the leading cause of preventable death worldwide. In addition, nicotine (NIC) is a key component of electronic and conventional cigarettes. Although nicotine’s addictive potential is well known, its health effects are not entirely understood. Thus, the main objective of the present study was to evaluate its toxicological profile both in vitro, at the level of three healthy cell lines, and in ovo, at the level of the chorioallantoic membrane. Five different concentrations of nicotine were used in keratinocytes, cardiomyocytes, and hepatocytes for the purpose of evaluating cell viability, cell morphology, and its impact on nuclei. Additionally, the hen’s egg test on the chorioallantoic membrane (HET-CAM) method was used to assess the biocompatibility and irritant potential of the chorioallantoic membrane. Across all cell lines studied, nicotine was proven to be significantly damaging to cell viability, with th...
Background and Objectives: The consumption of dietary supplements has increased over the last dec... more Background and Objectives: The consumption of dietary supplements has increased over the last decades among pregnant women, becoming an efficient resource of micronutrients able to satisfy their nutritional needs during pregnancy. Furthermore, gestational drug administration might be necessary to treat several pregnancy complications such as hypertension. Folic acid (FA) and folate (FT) supplementation is highly recommended by clinicians during pregnancy, especially for preventing neural tube birth defects, while labetalol (LB) is a β-blocker commonly administered as a safe option for the treatment of pregnancy-related hypertension. Currently, the possible toxicity resulting from the co-administration of FA/FT and LB has not been fully evaluated. In light of these considerations, the current study was aimed at investigating the possible in vitro cardio- and hepato-toxicity of LB-FA and LB-FT associations. Materials and Methods: Five different concentrations of LB, FA, FT, and their ...
Timisoara Physical Education and Rehabilitation Journal, 2010
Aims: Once the biologic therapies have been used, the present-day medicine trend is to homogenize... more Aims: Once the biologic therapies have been used, the present-day medicine trend is to homogenize the treatment of the inflammatory autoimmune rheumatic diseases, meaning rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE). But, there is still the need to find out a common assessment instrument for this pathology. Methods: The study included 120 patients (40 patients with RA, 40 patients with AS, 20 patients with PsA and 20 patients with SLE). They were assessed at the beginning and at the end of the study period by using both DAS (Disease Activity Score) and HAQ (Health Assessment Questionnaire) scales. BASDAI (Bath AS Disease Activity Index) was used for AS patients and SLEDAI (SLE Disease Activity Index) for SLE patients. Results: The RA patients had significant improvements regarding both DAS and HAQ scores (DAS mean score was initially 4.49 and finally 3.75; HAQ mean score was initially 1.78 and finally 2.15; ...
Objective: To identify a spectrum of perspectives on functioning and health of patients with prim... more Objective: To identify a spectrum of perspectives on functioning and health of patients with primary Sjögren's syndrome (pSS) from the five European countries in order to reveal commonalities and insights in their experiences.Methods: A multicenter focus group study on the patients with pSS about their perspectives of functioning and health was performed. Focus groups were chaired by trained moderators based on an interview guide, audiotaped, and transcribed. After conducting a meaning condensation analysis of each focus group, we subsequently combined the extracted concepts from each country and mapped them to the International Classification of Functioning, Disability and Health (ICF).Results: Fifty-one patients with pSS participated in 12 focus groups. We identified a total of 82 concepts meaningful to people with pSS. Of these, 55 (67%) were mentioned by the patients with pSS in at least four of five countries and 36 (44%) emerged in all the five countries. Most concepts wer...
The most common types of crystal arthropathies are gout and calcium pyrophosphate deposition (CPP... more The most common types of crystal arthropathies are gout and calcium pyrophosphate deposition (CPPD) disease. Serum urate levels are influenced by a combination of genetic factors and the environment. There are studies estimating the heritability of urate ranging from 45% to 73%. Approximately 3% of the variance in serum urate level is explained by the locus SLC2A9. Among the Caucasian population, 10% of all gout cases may be largely attributable to locus ABCG2. Loss or reduction function of ABCG2 halves the kidney’s ability to secrete uric acid. Gain-of-function mutations in ENPP1 gene may be involved in the development of CPPD disease. Loss-of-function mutations in ANKH leads to excess calcium hydroxyapatite formation. Conclusions: There is reason to believe that studying susceptibility genes for the crystal arthropathies will contribute to our understanding of the complexity of inheritance of these disorders. At present many other genes involved in crystal arthropathies are being ...
Background: Non-adherence to medication and non-pharmacological interventions precludes reaching ... more Background: Non-adherence to medication and non-pharmacological interventions precludes reaching an optimal outcome. 30 to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to their recommended treatment regimens. Objectives: The objective of this EULAR task force was to establish recommendations/points to consider (PtC) for the detection, assessment and management of non-adherence in people with RMDs. Methods: A EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included rheumatologists, health professionals in rheumatology (HPRs), and patient-representatives from 12 countries. A systematic literature review of reviews was conducted in advance to support the TF in formulating the PtC. Agreement was obtained by Delphi technique in three rounds (0-10 rating scale). Results: A definition of adherence, 4 overarching principles and 9 PtC were formulated (table). Conclusio...
Objective: We aimed at comparing and assessing the discriminative ability and correlation of the ... more Objective: We aimed at comparing and assessing the discriminative ability and correlation of the Bath Ankylosing Spondylitis (AS) Functional Index (BASFI) with several disease activity indexes used in ankylosing spondylitis (AS), together with other variables related to the patients (age, gender, etc.), in order to identify the relevant ones for patients and doctors. Material and methods: During a three-month period, we studied 31 patients, all diagnosed with AS at different stages with respect to the European Spondylarthropathy Study Group criteria and the Modified New York criteria for AS. The data were analyzed by statistical correlation. Results: At the baseline we found significant correlation between the functional status of the patients evaluated by the BASFI score and ASDAS ESR (r 2
Despite the reported benefits of intravenous iron therapy (IVIT) for correcting iron deficiency a... more Despite the reported benefits of intravenous iron therapy (IVIT) for correcting iron deficiency anemia (IDA) before any major surgery and the evidence thereof, perioperative allogenic blood transfusion (ABT) practice is still considered as the only viable option by some clinicians worldwide. As ABT increases the likelihood of infections, cardiac complications, longer hospital stays and mortality among the patients, the practice of ABT should only be reserved for critical cases (Hb level < 7 g/dl). Timely iron studies and iron replenishment (oral/IV) of prospective surgical patients could help decrease the ABT practice, and prove beneficial from both the clinical and economic standpoint. Evidence based patient blood management guidelines should be developed and standardized for use by clinicians worldwide. These guidelines should include specific instructions on timely assessment of surgical patients for correction of their IDA by either oral iron supplementation, if time permits,...
Introduction Occupational balance is an important and widely used concept in occupational therapy... more Introduction Occupational balance is an important and widely used concept in occupational therapy and occupational science. There is, however, not one unified definition in use, but several different ones, and thus instruments that measure the concept in research studies are diverse as well. Consequently, it is unclear how instruments and definitions correspond. The purpose of this study was to examine the coverage of occupational balance definitions by occupational balance instruments. Method Within a mixed-methods design we conducted a qualitative and quantitative content analysis of definitions and items of existing instruments. Definitions and items were extracted from articles identified in a systematic literature search. The extent of congruence and coverage between definitions and instruments was examined. Results The definitions used in 47 articles were structured into 19 categories. The categories which were found in most definitions were a balance of ‘various occupational ...
Objective: To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonar... more Objective: To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. Design: Randomized controlled study. Setting: Rheumatic Rehabilitation Centre. Subjects: A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. Interventions: Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. Main measures: Resting pulmonary function (forced vital capacity − FVC, forced expiratory volume in one second − FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide – VE/VO2 and VE/VCO2) a...
BackgroundOngoing education of health professionals in rheumatology (HPR) is critical for high-qu... more BackgroundOngoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings.Methods and participantsWe developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed theChecklist for Reporting Results of Internet E-Surveysguideline.ResultsThe questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries we...
Objectives: Soft and hard tissue breakdown was histologically and radiologically assessed around ... more Objectives: Soft and hard tissue breakdown was histologically and radiologically assessed around implants with alternate, consecutively placed ligatures on the same edentulous dog hemimandible. The influence of ligatured implants (LI) on adjacent non-ligatured implants (NLI, as a possible naturally induced peri-implantitis) was also evaluated. Material and Methods: Three months after tooth extraction, five dental implants were placed in the dog hemimandible. Two months after abutment placement, ligatures were placed subsequently two months apart on alternate implants, while both intermediate implants were left without ligatures. Ligatures were kept in place during the entire experiment, and no plaque control measures were taken. Eleven months post-implantation, the animal was sacrificed. Undecalcified ground sections were cut, stained with Masson Goldner and MOVAT Pentachrome and evaluated by light microscopy. Soft and hard tissue loss was assessed using histomorphometric and CBCT p...
International Journal of Environmental Research and Public Health
The use of tobacco products is a major global public health issue, as it is the leading cause of ... more The use of tobacco products is a major global public health issue, as it is the leading cause of preventable death worldwide. In addition, nicotine (NIC) is a key component of electronic and conventional cigarettes. Although nicotine’s addictive potential is well known, its health effects are not entirely understood. Thus, the main objective of the present study was to evaluate its toxicological profile both in vitro, at the level of three healthy cell lines, and in ovo, at the level of the chorioallantoic membrane. Five different concentrations of nicotine were used in keratinocytes, cardiomyocytes, and hepatocytes for the purpose of evaluating cell viability, cell morphology, and its impact on nuclei. Additionally, the hen’s egg test on the chorioallantoic membrane (HET-CAM) method was used to assess the biocompatibility and irritant potential of the chorioallantoic membrane. Across all cell lines studied, nicotine was proven to be significantly damaging to cell viability, with th...
Background and Objectives: The consumption of dietary supplements has increased over the last dec... more Background and Objectives: The consumption of dietary supplements has increased over the last decades among pregnant women, becoming an efficient resource of micronutrients able to satisfy their nutritional needs during pregnancy. Furthermore, gestational drug administration might be necessary to treat several pregnancy complications such as hypertension. Folic acid (FA) and folate (FT) supplementation is highly recommended by clinicians during pregnancy, especially for preventing neural tube birth defects, while labetalol (LB) is a β-blocker commonly administered as a safe option for the treatment of pregnancy-related hypertension. Currently, the possible toxicity resulting from the co-administration of FA/FT and LB has not been fully evaluated. In light of these considerations, the current study was aimed at investigating the possible in vitro cardio- and hepato-toxicity of LB-FA and LB-FT associations. Materials and Methods: Five different concentrations of LB, FA, FT, and their ...
Timisoara Physical Education and Rehabilitation Journal, 2010
Aims: Once the biologic therapies have been used, the present-day medicine trend is to homogenize... more Aims: Once the biologic therapies have been used, the present-day medicine trend is to homogenize the treatment of the inflammatory autoimmune rheumatic diseases, meaning rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE). But, there is still the need to find out a common assessment instrument for this pathology. Methods: The study included 120 patients (40 patients with RA, 40 patients with AS, 20 patients with PsA and 20 patients with SLE). They were assessed at the beginning and at the end of the study period by using both DAS (Disease Activity Score) and HAQ (Health Assessment Questionnaire) scales. BASDAI (Bath AS Disease Activity Index) was used for AS patients and SLEDAI (SLE Disease Activity Index) for SLE patients. Results: The RA patients had significant improvements regarding both DAS and HAQ scores (DAS mean score was initially 4.49 and finally 3.75; HAQ mean score was initially 1.78 and finally 2.15; ...
Objective: To identify a spectrum of perspectives on functioning and health of patients with prim... more Objective: To identify a spectrum of perspectives on functioning and health of patients with primary Sjögren's syndrome (pSS) from the five European countries in order to reveal commonalities and insights in their experiences.Methods: A multicenter focus group study on the patients with pSS about their perspectives of functioning and health was performed. Focus groups were chaired by trained moderators based on an interview guide, audiotaped, and transcribed. After conducting a meaning condensation analysis of each focus group, we subsequently combined the extracted concepts from each country and mapped them to the International Classification of Functioning, Disability and Health (ICF).Results: Fifty-one patients with pSS participated in 12 focus groups. We identified a total of 82 concepts meaningful to people with pSS. Of these, 55 (67%) were mentioned by the patients with pSS in at least four of five countries and 36 (44%) emerged in all the five countries. Most concepts wer...
The most common types of crystal arthropathies are gout and calcium pyrophosphate deposition (CPP... more The most common types of crystal arthropathies are gout and calcium pyrophosphate deposition (CPPD) disease. Serum urate levels are influenced by a combination of genetic factors and the environment. There are studies estimating the heritability of urate ranging from 45% to 73%. Approximately 3% of the variance in serum urate level is explained by the locus SLC2A9. Among the Caucasian population, 10% of all gout cases may be largely attributable to locus ABCG2. Loss or reduction function of ABCG2 halves the kidney’s ability to secrete uric acid. Gain-of-function mutations in ENPP1 gene may be involved in the development of CPPD disease. Loss-of-function mutations in ANKH leads to excess calcium hydroxyapatite formation. Conclusions: There is reason to believe that studying susceptibility genes for the crystal arthropathies will contribute to our understanding of the complexity of inheritance of these disorders. At present many other genes involved in crystal arthropathies are being ...
Background: Non-adherence to medication and non-pharmacological interventions precludes reaching ... more Background: Non-adherence to medication and non-pharmacological interventions precludes reaching an optimal outcome. 30 to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to their recommended treatment regimens. Objectives: The objective of this EULAR task force was to establish recommendations/points to consider (PtC) for the detection, assessment and management of non-adherence in people with RMDs. Methods: A EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included rheumatologists, health professionals in rheumatology (HPRs), and patient-representatives from 12 countries. A systematic literature review of reviews was conducted in advance to support the TF in formulating the PtC. Agreement was obtained by Delphi technique in three rounds (0-10 rating scale). Results: A definition of adherence, 4 overarching principles and 9 PtC were formulated (table). Conclusio...
Objective: We aimed at comparing and assessing the discriminative ability and correlation of the ... more Objective: We aimed at comparing and assessing the discriminative ability and correlation of the Bath Ankylosing Spondylitis (AS) Functional Index (BASFI) with several disease activity indexes used in ankylosing spondylitis (AS), together with other variables related to the patients (age, gender, etc.), in order to identify the relevant ones for patients and doctors. Material and methods: During a three-month period, we studied 31 patients, all diagnosed with AS at different stages with respect to the European Spondylarthropathy Study Group criteria and the Modified New York criteria for AS. The data were analyzed by statistical correlation. Results: At the baseline we found significant correlation between the functional status of the patients evaluated by the BASFI score and ASDAS ESR (r 2
Despite the reported benefits of intravenous iron therapy (IVIT) for correcting iron deficiency a... more Despite the reported benefits of intravenous iron therapy (IVIT) for correcting iron deficiency anemia (IDA) before any major surgery and the evidence thereof, perioperative allogenic blood transfusion (ABT) practice is still considered as the only viable option by some clinicians worldwide. As ABT increases the likelihood of infections, cardiac complications, longer hospital stays and mortality among the patients, the practice of ABT should only be reserved for critical cases (Hb level < 7 g/dl). Timely iron studies and iron replenishment (oral/IV) of prospective surgical patients could help decrease the ABT practice, and prove beneficial from both the clinical and economic standpoint. Evidence based patient blood management guidelines should be developed and standardized for use by clinicians worldwide. These guidelines should include specific instructions on timely assessment of surgical patients for correction of their IDA by either oral iron supplementation, if time permits,...
Introduction Occupational balance is an important and widely used concept in occupational therapy... more Introduction Occupational balance is an important and widely used concept in occupational therapy and occupational science. There is, however, not one unified definition in use, but several different ones, and thus instruments that measure the concept in research studies are diverse as well. Consequently, it is unclear how instruments and definitions correspond. The purpose of this study was to examine the coverage of occupational balance definitions by occupational balance instruments. Method Within a mixed-methods design we conducted a qualitative and quantitative content analysis of definitions and items of existing instruments. Definitions and items were extracted from articles identified in a systematic literature search. The extent of congruence and coverage between definitions and instruments was examined. Results The definitions used in 47 articles were structured into 19 categories. The categories which were found in most definitions were a balance of ‘various occupational ...
Objective: To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonar... more Objective: To evaluate the impact of inspiratory muscle training on aerobic capacity and pulmonary function in patients with ankylosing spondylitis. Design: Randomized controlled study. Setting: Rheumatic Rehabilitation Centre. Subjects: A total of 54 ankylosing spondylitis patients, all males, were randomized to a conventional exercise training associated with an inspiratory muscle training group, or to a conventional exercise training group. Interventions: Group 1 (27 patients) performed eight weeks of conventional exercise training (supervised weekly group sessions followed by a home-based exercise programme) associated with inspiratory muscle training sessions. Group 2 (27 patients) received eight weeks of conventional exercise training only. Main measures: Resting pulmonary function (forced vital capacity − FVC, forced expiratory volume in one second − FEV1); effort ventilatory efficiency (lowest ventilatory equivalent ratio for oxygen and carbon dioxide – VE/VO2 and VE/VCO2) a...
Uploads
Papers by Razvan Dragoi