Background: Cardiovascular diseases are an important public health problem, the main cause of dea... more Background: Cardiovascular diseases are an important public health problem, the main cause of death in both men and women, with a continuous increasing prevalence and consequences upon morbidity in economic, physical, and psychological terms. The new technology have made possible the development of innovative devices, which have increased the possibility of therapeutic interventions today, extending the life of the population with cardiovascular pathology, transforming the patient care, and providing a complex, personalized therapeutic approach. Fields of Uncertainty: The aim of the study was to evaluate from an ethical perspective the need, feasibility, and safety of reusing cardiac pacemakers to revise the legal terms and requirements. In recent years, the problem of accessibility to cardiovascular drugs has been increasingly accompanied by the accessibility to technology, interventional cardiology advancing recently, and becoming an increasingly important standard of care. Data Sources: A review of the specialized literature was performed in March 2023, using keywords such as implantable cardiac devices, reuse, ethics from PubMed, Scopus, Web of Science, and Google Scholar, as well as official documents issued at the international level (World Health Organization). Ethics and Therapeutic Advances: An ethical analysis assesses the extent to which a medical act (PM reimplantation) is covered by the 4 universally accepted principles: nonmaleficence, beneficence, autonomy (respect for the person), and social justice, the analysis addressing to the risk–benefit ratio based on studies that analyzed the phenomenon over the past 50 years. The ethical analyzed issues start from the fact that although 80% of pacemakers, most of them working perfectly, with a battery life of more than 7 years are buried with their owners, while approximately 3 million patients die annually due to the lack of access to these devices in undeveloped and developing countries. But beyond the ethical issues, legal practice has meant that in many countries, reusing of these devices is prohibited, mostly being single-use devices. Low-income countries continue to accept this practice as the only one economically accessible to them, considering the prohibition of reusing them to be an economic rather than a medical issue. Conclusions: Reusing implantable cardiac devices is of great interest because of the costs, being in certain situations, the only possibility that certain people can have access to a therapeutic method that ensures their health recovery and increases their quality of life. But this is not possible without clear procedures, without clear criteria on how sterilization should be performed, how the technique should be performed, without obtaining a truly informed consent, and especially without a proper patient's follow-up.
The evolution of the sexuality of mankind was produced by a continuous and parallel process toget... more The evolution of the sexuality of mankind was produced by a continuous and parallel process together with humanization and urbanism. This is why human sexuality overcame the natural instinct of perpetuation of species and obtained a more important psychological and social component (society is the only body to define the limits between normal and pathological behaviour). Depending on the socio-cultural and moral factors, sexual instinct (sexual motivation) having a strong heredity component and also an affective one, could be defeated, sublimated or deviated.
Inlăturarea obstacolelor tehnice in realizarea transplantului si rezolvarea problemei reprezent... more Inlăturarea obstacolelor tehnice in realizarea transplantului si rezolvarea problemei reprezentate de rejetul grefei au condus la o dezvoltare in domeniul transplantului de organe ce a permis salvarea vieţii multor bolnavi. A apărut insă o altă problemă, dificil de controlat si incă nerezolvată, reprezentată de numărul redus de organe disponibile comparativ cu numărul potenţialilor primitori. Activitatea de transplant din intreaga lume se confruntă cu o veritabilă „criză a organelor”, ce determină presiuni asupra sistemelor medicale naţionale pentru a elabora cele mai adecvate politici de sănătate. De aici si apariţia traficului ilegal de organe, o piaţă care s-a dezvoltat constant si care pune in pericol insăsi legitimitatea transplantului ca metodă terapeutică. O problemă etică o reprezintă si modul in care sunt protejate drepturile donatorului viu.
In a review of the data in the literature completed with authors own researches (concerned with t... more In a review of the data in the literature completed with authors own researches (concerned with twins, chromosome abnormalities, incestuous descent, socially assisted children etc.) an integrative model regarding the ontogenesis and destruction of human behaviour is presented. According to this model, behaviour appears as a hierarchical and integrated system expressing the process of its development from automatic and reactive to noologic and reflexive. The integrative, systemic concept promotes, theoretically and methodologically, the understanding and competent investigation of human behaviour in its two fundamental states, integrated and destructive.
The concept of retrogenesis has been documented by several studies as the process by which degene... more The concept of retrogenesis has been documented by several studies as the process by which degenerative mechanisms in Alzheimer’s disease (AD) reverse the order of acquisition in normal human development. The objective of the present study is to offer expert opinion on the possible ethical and forensic implications of retrogenesis. In this regard, we constructed a six-item instrument called “Questionnaire regarding possible ethical and forensic implications of retrogenesis”, which we applied to three professional groups that are directly involved in clinical and forensic evaluation of AD persons, namely, psychiatrists, psychologists and forensic pathologists. The majority of experts questioned in this survey considered it ethical to start from the concept of retrogenesis when approaching AD. Moreover, most of the study participants agreed that it would be ethical to use psychometric tests and programs of cognitive stimulation for the child in the patient with AD. It can also be noted that more than half of the professionals involved in our study considered it ethical to apply child abuse evaluation tests to the AD patients. Furthermore, 61.2% of the opinion survey respondents agreed that it would be necessary to use the concept of retrogenesis for assessing mental capacity in these patients. In addition, most professionals surveyed herein pointed out that it would be necessary to enact legislative proposals on the protection of the patient with AD which would be adapted from the model of the current child protection legislation. This study appears to represent the first expert opinion survey that concerns the ethical and forensic implications of the concept of retrogenesis in AD.
Ionizing radiations are considered to be risk agents that are responsible for the effects on inte... more Ionizing radiations are considered to be risk agents that are responsible for the effects on interaction with living matter. The occurring biological effects are due to various factors such as: dose, type of radiation, exposure time, type of biological tissue, health condition and the age of the person exposed. The mechanisms involved in the direct modifications of nuclear DNA and mitochondrial DNA are reviewed. Classical target theory of energy deposition in the nucleus that causes DNA damages, in particular DNA double-strand breaks and that explanation of the biological consequences of ionizing radiation exposure is a paradigm in radiobiology. Recent experimental evidences have demonstrated the existence of a molecular mechanism that explains the non-targeted effects of ionizing radiation exposure. Among these novel data, genomic instability and a variety of bystander effects are discussed here. Those bystander effects of ionizing radiation are fulfilled by cellular communication systems that give rise to non-targeted effects in the neighboring non irradiated cells. This paper provides also a commentary on the synergistic effects induced by the co-exposures to ionizing radiation and various physical agents such as electromagnetic fields and the co-exposures to ionizing radiation and chemical environmental contaminants such as metals. The biological effects of multiple stressors on genomic instability and bystander effects are also discussed. Moreover, a brief presentation of the methods used to characterize cyto- and genotoxic damages is offered.
Oare dezumanizarea medicinei nu incepe cu modalitatea de selecţie? In fiecare an, concuren... more Oare dezumanizarea medicinei nu incepe cu modalitatea de selecţie? In fiecare an, concurenţa la universităţile de medicină si farmacie din România este tot mai mare, in ciuda faptului că numărul de absolvenţi cu Bacalaureat este mai mic. Cu toate acestea, cadrele didactice se plâng mai tot timpul de calitatea studenţilor. Trebuie deci să ne intrebăm dacă nu cumva modul de selecţie a viitorilor medici nu este cel mai adecvat.
Starting from the "epistemological naturalization of sciences of life", the authors present the c... more Starting from the "epistemological naturalization of sciences of life", the authors present the complex content of medico-legal psychiatric examination, from which will result its scientific structure. The ontological, epistemological, hermeneutical and axiological content of this type of examination emphasize its methodological structure in the purpose of combining in a creative way its humanistic and scientific features.
The promotion, prescription and dispensing of drugs are influenced by a series of factors and att... more The promotion, prescription and dispensing of drugs are influenced by a series of factors and attempts to face dilemmas often distance companies, physicians or pharmacists from patients, those who are supposed to be the main beneficiaries of healthcare services. Purpose of the study: identifying pharmacists' perception of doctor’s practices regarding drug prescription. Material and methods: A number of 72 pharmacists have answered a survey about doctors’ practices of drug prescription to patients. Variables like age, work environment (urban, rural), length of employment have been taken into consideration. Results: in pharmacists’ view, doctors take into consideration the protocol about 40% while they are prescribing; in their opinion, over 95% of doctors respect the budgetary limitations from the National Health Insurance House. They consider that 65% of doctors are influenced by their relationship with the medical representative. Conclusions: Pharmacists’ view on doctors’ presc...
This article analyses the results of a research that aimed to measure the interest and degree of ... more This article analyses the results of a research that aimed to measure the interest and degree of satisfaction of students in the three prestigious medical universities participating in the project entitled “Education for non-discrimination in universities of Medicine and Pharmacy in Romania – a new approach” enrolled in the implemented optional course “Ethics and Non-discrimination of Vulnerable Groups within the Healthcare System”. This course raised the students’ awareness on the concept of discrimination, on the ethical foundations prohibiting discrimination of patients and on the law governing this concept and enabled them to find "prophylactic" solutions against this phenomenon. During the evaluation process we were able to collect 172 questionnaires filled in by students: 97 students at Iasi UMP (56.40%), 37 students at Cluj Napoca UMP (21.51%) and 38 students from Tirgu Mures UMP (22.09%). In the first section, the fourteen items valued through Likert scale focused on the course content, the teaching methodology, the students’ assessment of lecturers - trainers and usefulness of this course. The second part referred to the strengths and weaknesses of the course as well as students' suggestions regarding the improvement and refinement of the course content.
Background: Cardiovascular diseases are an important public health problem, the main cause of dea... more Background: Cardiovascular diseases are an important public health problem, the main cause of death in both men and women, with a continuous increasing prevalence and consequences upon morbidity in economic, physical, and psychological terms. The new technology have made possible the development of innovative devices, which have increased the possibility of therapeutic interventions today, extending the life of the population with cardiovascular pathology, transforming the patient care, and providing a complex, personalized therapeutic approach. Fields of Uncertainty: The aim of the study was to evaluate from an ethical perspective the need, feasibility, and safety of reusing cardiac pacemakers to revise the legal terms and requirements. In recent years, the problem of accessibility to cardiovascular drugs has been increasingly accompanied by the accessibility to technology, interventional cardiology advancing recently, and becoming an increasingly important standard of care. Data Sources: A review of the specialized literature was performed in March 2023, using keywords such as implantable cardiac devices, reuse, ethics from PubMed, Scopus, Web of Science, and Google Scholar, as well as official documents issued at the international level (World Health Organization). Ethics and Therapeutic Advances: An ethical analysis assesses the extent to which a medical act (PM reimplantation) is covered by the 4 universally accepted principles: nonmaleficence, beneficence, autonomy (respect for the person), and social justice, the analysis addressing to the risk–benefit ratio based on studies that analyzed the phenomenon over the past 50 years. The ethical analyzed issues start from the fact that although 80% of pacemakers, most of them working perfectly, with a battery life of more than 7 years are buried with their owners, while approximately 3 million patients die annually due to the lack of access to these devices in undeveloped and developing countries. But beyond the ethical issues, legal practice has meant that in many countries, reusing of these devices is prohibited, mostly being single-use devices. Low-income countries continue to accept this practice as the only one economically accessible to them, considering the prohibition of reusing them to be an economic rather than a medical issue. Conclusions: Reusing implantable cardiac devices is of great interest because of the costs, being in certain situations, the only possibility that certain people can have access to a therapeutic method that ensures their health recovery and increases their quality of life. But this is not possible without clear procedures, without clear criteria on how sterilization should be performed, how the technique should be performed, without obtaining a truly informed consent, and especially without a proper patient's follow-up.
The evolution of the sexuality of mankind was produced by a continuous and parallel process toget... more The evolution of the sexuality of mankind was produced by a continuous and parallel process together with humanization and urbanism. This is why human sexuality overcame the natural instinct of perpetuation of species and obtained a more important psychological and social component (society is the only body to define the limits between normal and pathological behaviour). Depending on the socio-cultural and moral factors, sexual instinct (sexual motivation) having a strong heredity component and also an affective one, could be defeated, sublimated or deviated.
Inlăturarea obstacolelor tehnice in realizarea transplantului si rezolvarea problemei reprezent... more Inlăturarea obstacolelor tehnice in realizarea transplantului si rezolvarea problemei reprezentate de rejetul grefei au condus la o dezvoltare in domeniul transplantului de organe ce a permis salvarea vieţii multor bolnavi. A apărut insă o altă problemă, dificil de controlat si incă nerezolvată, reprezentată de numărul redus de organe disponibile comparativ cu numărul potenţialilor primitori. Activitatea de transplant din intreaga lume se confruntă cu o veritabilă „criză a organelor”, ce determină presiuni asupra sistemelor medicale naţionale pentru a elabora cele mai adecvate politici de sănătate. De aici si apariţia traficului ilegal de organe, o piaţă care s-a dezvoltat constant si care pune in pericol insăsi legitimitatea transplantului ca metodă terapeutică. O problemă etică o reprezintă si modul in care sunt protejate drepturile donatorului viu.
In a review of the data in the literature completed with authors own researches (concerned with t... more In a review of the data in the literature completed with authors own researches (concerned with twins, chromosome abnormalities, incestuous descent, socially assisted children etc.) an integrative model regarding the ontogenesis and destruction of human behaviour is presented. According to this model, behaviour appears as a hierarchical and integrated system expressing the process of its development from automatic and reactive to noologic and reflexive. The integrative, systemic concept promotes, theoretically and methodologically, the understanding and competent investigation of human behaviour in its two fundamental states, integrated and destructive.
The concept of retrogenesis has been documented by several studies as the process by which degene... more The concept of retrogenesis has been documented by several studies as the process by which degenerative mechanisms in Alzheimer’s disease (AD) reverse the order of acquisition in normal human development. The objective of the present study is to offer expert opinion on the possible ethical and forensic implications of retrogenesis. In this regard, we constructed a six-item instrument called “Questionnaire regarding possible ethical and forensic implications of retrogenesis”, which we applied to three professional groups that are directly involved in clinical and forensic evaluation of AD persons, namely, psychiatrists, psychologists and forensic pathologists. The majority of experts questioned in this survey considered it ethical to start from the concept of retrogenesis when approaching AD. Moreover, most of the study participants agreed that it would be ethical to use psychometric tests and programs of cognitive stimulation for the child in the patient with AD. It can also be noted that more than half of the professionals involved in our study considered it ethical to apply child abuse evaluation tests to the AD patients. Furthermore, 61.2% of the opinion survey respondents agreed that it would be necessary to use the concept of retrogenesis for assessing mental capacity in these patients. In addition, most professionals surveyed herein pointed out that it would be necessary to enact legislative proposals on the protection of the patient with AD which would be adapted from the model of the current child protection legislation. This study appears to represent the first expert opinion survey that concerns the ethical and forensic implications of the concept of retrogenesis in AD.
Ionizing radiations are considered to be risk agents that are responsible for the effects on inte... more Ionizing radiations are considered to be risk agents that are responsible for the effects on interaction with living matter. The occurring biological effects are due to various factors such as: dose, type of radiation, exposure time, type of biological tissue, health condition and the age of the person exposed. The mechanisms involved in the direct modifications of nuclear DNA and mitochondrial DNA are reviewed. Classical target theory of energy deposition in the nucleus that causes DNA damages, in particular DNA double-strand breaks and that explanation of the biological consequences of ionizing radiation exposure is a paradigm in radiobiology. Recent experimental evidences have demonstrated the existence of a molecular mechanism that explains the non-targeted effects of ionizing radiation exposure. Among these novel data, genomic instability and a variety of bystander effects are discussed here. Those bystander effects of ionizing radiation are fulfilled by cellular communication systems that give rise to non-targeted effects in the neighboring non irradiated cells. This paper provides also a commentary on the synergistic effects induced by the co-exposures to ionizing radiation and various physical agents such as electromagnetic fields and the co-exposures to ionizing radiation and chemical environmental contaminants such as metals. The biological effects of multiple stressors on genomic instability and bystander effects are also discussed. Moreover, a brief presentation of the methods used to characterize cyto- and genotoxic damages is offered.
Oare dezumanizarea medicinei nu incepe cu modalitatea de selecţie? In fiecare an, concuren... more Oare dezumanizarea medicinei nu incepe cu modalitatea de selecţie? In fiecare an, concurenţa la universităţile de medicină si farmacie din România este tot mai mare, in ciuda faptului că numărul de absolvenţi cu Bacalaureat este mai mic. Cu toate acestea, cadrele didactice se plâng mai tot timpul de calitatea studenţilor. Trebuie deci să ne intrebăm dacă nu cumva modul de selecţie a viitorilor medici nu este cel mai adecvat.
Starting from the "epistemological naturalization of sciences of life", the authors present the c... more Starting from the "epistemological naturalization of sciences of life", the authors present the complex content of medico-legal psychiatric examination, from which will result its scientific structure. The ontological, epistemological, hermeneutical and axiological content of this type of examination emphasize its methodological structure in the purpose of combining in a creative way its humanistic and scientific features.
The promotion, prescription and dispensing of drugs are influenced by a series of factors and att... more The promotion, prescription and dispensing of drugs are influenced by a series of factors and attempts to face dilemmas often distance companies, physicians or pharmacists from patients, those who are supposed to be the main beneficiaries of healthcare services. Purpose of the study: identifying pharmacists' perception of doctor’s practices regarding drug prescription. Material and methods: A number of 72 pharmacists have answered a survey about doctors’ practices of drug prescription to patients. Variables like age, work environment (urban, rural), length of employment have been taken into consideration. Results: in pharmacists’ view, doctors take into consideration the protocol about 40% while they are prescribing; in their opinion, over 95% of doctors respect the budgetary limitations from the National Health Insurance House. They consider that 65% of doctors are influenced by their relationship with the medical representative. Conclusions: Pharmacists’ view on doctors’ presc...
This article analyses the results of a research that aimed to measure the interest and degree of ... more This article analyses the results of a research that aimed to measure the interest and degree of satisfaction of students in the three prestigious medical universities participating in the project entitled “Education for non-discrimination in universities of Medicine and Pharmacy in Romania – a new approach” enrolled in the implemented optional course “Ethics and Non-discrimination of Vulnerable Groups within the Healthcare System”. This course raised the students’ awareness on the concept of discrimination, on the ethical foundations prohibiting discrimination of patients and on the law governing this concept and enabled them to find "prophylactic" solutions against this phenomenon. During the evaluation process we were able to collect 172 questionnaires filled in by students: 97 students at Iasi UMP (56.40%), 37 students at Cluj Napoca UMP (21.51%) and 38 students from Tirgu Mures UMP (22.09%). In the first section, the fourteen items valued through Likert scale focused on the course content, the teaching methodology, the students’ assessment of lecturers - trainers and usefulness of this course. The second part referred to the strengths and weaknesses of the course as well as students' suggestions regarding the improvement and refinement of the course content.
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