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MOTIVATIONS, NEEDS AND ATTITUDES OF TOURIST CONSUMERS IN ADVENTURE TOURISM For billions of tourists around the world - those who want to travel in search of unique experiences - adventure travel has become a cornerstone of the tourist experience. Indeed, as we move towards a more globalized world, consumers are increasingly looking for authentic experiences, and adventure tourism is undoubtedly one of the segments in high demand. For travelers, adventure tourism means an experiential holiday; adding value as they learn and interact with local people and connect with their core values. For companies and travel destinations, adventure tourism attracts off-peak visitors, highlights a destination's natural and cultural values, thereby promoting conservation, helping to differentiate destinations from competitors and creating resilient and engaged travelers. These are just some of the reasons why it is essential that businesses understand and work with adventure tourism professionals., {"references":["1. Carvache-Franco Mauricio, Contreras-Moscol Daniel Orden-Mejía Miguel, et.al. Motivations and Loyalty of the Demand for Adventure Tourism as Sustainable Travel. In: Sustainability, 14 (14), 8472, 2022. 17 p.","2. Frleta Soldić. Shifts in tourists' attitudes towards the destination offering. In: Tourism and Hospitality Management, Vol. 24, No. 2, 2018. 15 p.","3. Oprea D., Mesnita G., Alexa M. Managementul evenimentelor : personale, organizationale, internationale. Iasi : Polirom, 2016. 248 p.","4. Platon Nicolae. Motivația turiștilor - factor determinant al circulației turistice. In: Journal \"Economica\", nr.4 (106), 2018. p.7-19","5. Stange Jennifer, Brown David. Tourism destination management achieving sustainable and competitive results. Washington: International Institute for Tourism Studies, 2017. 142 p.","6. Th Lee, Ch Tseng, Fh Jan. Risk-Taking Attitude and Behavior of Adventure Recreationists: A Review. In: Journal of Tourism & Hospitality, 2015. 3 p.","7. Yousaf Anish, Amin Insha, Santos Jose Antonio C. Tourists' motivations to travel: a theoretical perspective on the existing literature. In: Tourism and Hospitality Management, Vol. 24, No. 1, 2018. p. 197-211."]}

This article aims to focus on the lesser known issues related to the impact of tourism on destinations. The author will analyze this impact from the perspective of sustainable development, a concept that found its place much later than it should have in the universe of research in tourism studies. This article is logically structured in three directions of research, as follows: the first part will analyze the main effects of tourism on destinations from the perspective of sustainable development; the second part will focus on a similar analysis, but focused on the human dimension; the third part will focus on the recent "dispute" in the literature between the importance of building new tourism development strategies from the perspective of sustainable development, suggesting an appropriate solution to integrate the two visions into a common approach., {"references":["1.\tButler R. W. (2018), Challenges and opportunities, Worldwide Hospitality and Tourism Themes 10(6): 635–641.","2.\tChhetri A., Chhetri P., Arrowsmith C., Corcoran J. (2017), Modelling tourism and hospitality employment clusters: a spatial econometric approach, Tourism Geographies 19(3): 398–424.","3.\tCoroș M. M., Gica O. A., Yallop A. C., Moisescu O. I. (2017), Innovative and sustainable tourism strategies: a viable alternative for Romania's economic development, Worldwide Hospitality and Tourism Themes 9(5): 504–515.","4.\tGossling S., Peeters P. (2015), Assesing tourism's global environmental impact 1900‒2050, Journal of Sustainable Tourism 23(5): 639–659.","5.\tLacey G., Weiler B., Peel V. (2018), Sustainability or resilience? Poverty-related philantropic tourism as an agent for deliberate slow change, în: Cheer J. M., Lew A. A. (Ed.), Tourism, Resilience and Sustainability. Adapting to Social, Political and Economic Change, Routledge, New York.","6.\tSharpley R. (2015a), Tourism: A Vehicle for Development?, în: Sharpley, R., Telfer, D.J. (Ed.), Tourism and Development. Concepts and Issues, 2 nd Edition, Channel View Publications, p. 3–32.","7.\tPerez E. A., Nadal J. R. (2005), Host community perceptions: a cluster analysis. Annals of Tourism Research 32(4): 925–941.","8.\tRasoolimanesh S. M., Roldan J. L., Jaafar M., Ramayah T. (2017), Factors influencing residents' perceptions toward tourism development: differences across rural and urban World Heritage Sites, Journal of Travel Research 56(6): 1–16.","9.\tTelfer D. (2015), Tourism and Regional Development Issues, în: Sharpley R., Telfer D. J. (Ed.), Tourism and Development. Concepts and Issues, 2 nd Edition, Channel View Publications, p. 140–177","10. World Commission on Environment and Development (1987), Our common future, Oxford University Press, Oxford."]}

Summary In this article, the notion of contravention was analyzed in the light of the fact that its perpetration represents a violation of human rights, enshrined and guaranteed, both in national and international legislation. The analysis of some material norms from the Contravention Code of the Republic of Moldova was carried out, the content of which demonstrates that the purpose of the contravention law is to defend human rights and human interests, by preventing and combating the phenomenon of contravention. The State, through its competent bodies, applies coercive measures to fulfill the purpose of the contravention law., {"references":["1.\tPURDĂ N. Protecția drepturilor omului. București: Editura Lumina Lex, 2001.","2.\tConstituția Republicii Moldova din 29.07.1994, publicat","3.\tFURDUI, S. Dreptul Contravențional. Chișinău: Cartier, 2005.","4.\tDreptul Contravențional ca ramură distinctă a sistemului de drept, ma-terialele simpozionului științific studențesc universitar din 3 decembrie 2010. Chișinău 2011.","5.\tCodul contravențional al Republicii Moldova din 24.10.2008. În: Monito-rul Oficial al Republicii Moldova 2009, nr.3-6/15. Republicat în Monitorul Oficial al Republicii Moldova, 2017, nr.78-84.","6.\tHOTCĂ M. Drept contravențional. Partea generală. București: All Beck 2003.","PANTEA O., ANTOCI A. Drept contravențional. Suport de curs. Chișinău: Centrul editorial-poligrafic al USM, 2020.","8.\tOmbudsman.md [citat 25.12.2021]. Disponibil: http://old.ombudsman. md/ro/content/dreptul-la-ocrotirea-sanatatii-fragment-din-raportul-pri-vind-respectarea-drepturilor-omului.","9.\tLastrada.md [citat 25.12.2021]. Disponibil: http://lastrada.md/rom/vio-lenta-in-familie-si-violenta-sexuala.","10. Dosarul nr. 4-123/21. PIGD 4-21133664-21-4-09092021. [citat 25.12.2021]. Disponibil: https://instante.justice.md/ro/pigd_integrati-on/pdf/5EA940A0-DA19-4507-BC1B-D9F2443D0DFA"]}

The long Romanian transition period created a stagnation of the civil society. The paper presents some considerations regarding the role of civil society, focusing on the relationship with urban planning and also analyzing some possible solutions for improving its role with the aim of revigorating the Romanian society.

Pulmonary toxoplasmosis occurs mainly in immunosuppressed patients and its diagnosis mainly relies upon biological confirmation of the parasite. We present the case of a 47 years patient in medullar aplasia after induction chemotherapy for acute lymphoblastic leukemia that developed pulmonary infiltrates of parasitic origin. The diagnosis of pulmonary toxoplasmosis was established after identification of the parasite in brochioloalveolar lavage fluid (BAL) and peripheral blood. Serological tests are of limited utility in immunosuppressed patients. We used classical methods for the diagnosis of parasitosis but they are being replaced by molecular methods. Polymerase Chain Reaction (PCR) allows a highly specific and sensitive diagnosis on any sample but it cannot be performed in any center.

Epidemiological study on a statistically significant population for determining the true degree of Toxocara canis infections in the adults from Moldova, Romania.457 patients, 416 females and 41 males (91% and 9%, respectively) entered the study. Mean age of the investigated patients was 44.50 +/- 12.706 years, with small differences between sexes. 49.2% were from rural and 50.8% from urban areas. Data on living conditions, animals in the household, and source of drinking water were obtained through direct questioning. At present there is no definitive diagnostic method for Toxocara infection, as the actual sensitivity and specificity of serological tests cannot be determined accurately. IgG antibody titer specific for T. canis was assessed by ELISA in all study patients.Most infections were recorded in 2009 (51.4%), 15.3% in 2008, 17.1% in 2010 14.0% in 2011, and 2.2% (10 cases) in 2012. An IgG titer of 1/100 was found in 40.7% of the patients. Toxocariasis prevalence in our geographic area was 51.7%, without significant sex differences. However, while the percentages of negative determinations were similar for both sexes (42.5% in females and 46.3% in males), almost twice more men (9.8% vs. 4.6% women) had a 1/10 determination, while 21,4% of the women had a 1/50 determination as compared to 9,8% of the males. The source of water was not, at least in this study group, a major cause of disease in adults. The statistical results show a major and significant influence of human contact with the dog. Thus, in dog owners 1/50 and 1/100 determinations being found in equal percentages (26% of the total), while in those having both dogs and cats the 1/100 determination was the most common (40.7% of the total).Our data can be the basis for a nation-wide seroprevalence study and programs to eradicate this infection.

There is little information concerning asthma severity and sensitization to Ascaris lumbricoides in pediatric patients.The relationship between sensitization to Ascaris lumbricoides and asthma severity in 219 patients with a high prevalence of parasitic exposure (IgE antibodies) was studied by using linear, multivariate and logistic regression.Sensitization to Ascaris lumbricoides was associated with positive skin tests for aeroallergens, increased total serum IgE, increased eosinophils, reductions in FEV1 and FEV1/FVC ratio, increased airway Methacholine, bronchodilator responsiveness, and hospitalizations for asthma in the past year.Sensitization to Ascaris lumbricoides is associated with increased severity of asthma among Romanian children. This association is mediated by a high degree of atopy among the asthma children sensitized to Ascaris lumbricoides and belonging to a population with a low prevalence of helminthiasis.

The purpose of the current study was to examine the relationship between past and current intestinal helminth infections, and asthma, allergic rhino-conjunctivitis, and atopic dermatitis.The study was performed on 84 patients aged 2-18 years with a mean of 9.31 +/- 3.75 years. Helminth infection was determined by stool examinations and questionnaire. Asthma was diagnosed by spirometry, atopic dermatitis and allergic rhino-conjunctivitis by skin prick testing.Stool examinations revealed infection with A. lumbricoides in 5.95% of cases and E. vermicularis in 4.76% of cases. 8 patients had positive tests for at least a helminth. The most frequent respiratory symptoms were caught, wheezing and dispneea. Spirometry showed anormal results in 4.76% of patients and skin tests were positive in 20.24% of cases. 11 patients were diagnosed with allergic rhinoconjunctivitis and 5 with atopic dermatitis. A history of infection with E. vermicularis was associated with increased risk of atopic dermatitis (OR 1.86), asthma (OR 2.11), and allergic rhinoconjunctivitis (OR 1.34), and a positive stool examination for A. lumbricoides was negatively associated with asthma (OR 2.60).Current A. lumbricoides infection protects against asthma while past infection with E. vermicularis are risk factors for allergic rhinoconjunctivitis, asthma and atopic dermatitis. Interactions depend on the type of helminth and time of infestation.

The authors present the results of retroprospective epidemiological, clinical and laboratory diagnosis on toxocariasis cases hospitalized in the Paediatric Diseases Clinic of Iaşi, between January 2005- June 2008.The study included a number of 228 children.Cutaneous manifestations were present in 65 children: 30 boys (46.15%) and 34 girls (52.30%), with a slight advance of the urban environment (53.84%). The age distribution highlighted a predominance of 1-6 age (66.15%). Cutaneous manifestations were pruritus, urticaria, atopic dermatitis, prurigo. The distribution of toxocariasis in children patients in Moldavia, Romania, highlighted a predominance in Iaşi. The laboratory diagnosis of the children with cutaneous manifestations: hypereosinophilia was present on 87.69% of the children associated with hyperleucocytosis. All the patients were serologicaly confirmed with toxocariasis. The children responded well to treatment with albendazole.

The authors present the results of retroprospective clinical and laboratory diagnosis on toxocariasis cases hospitalized in the Paediatric Diseases Clinic of Iaşi, between January 2005-June 2008.The study included a number of 228 children.The most frequent clinical manifestation was pulmonary symptoms 80.70%: dyspneea, wheesing, asthma, cough, interstitial pneumonitis. The most frequent digestive symptoms were abdominal pain 41.22%, hepatosplenomegaly 29.38%; cutaneous manifestations were pruritus and urticaria. The laboratory diagnosis: hypereosinophilia was present at 94.73% childrens associated with hyperleucocytosis and hyper-gammaglobulinemia. All the patients were serologic confirmed with toxocariasis. The children responded well to treatment with albendazole.

Leptospirosis is a zooantroponosis manifested as an infection with a severe evolution, with liver and renal failure and haemoragic manifestation. The aim of the study was to present the epidemiologic, clinic and therapeutical aspects of 100 cases of leptospirosis admitted in the clinic of Infectious Diseases of Iaşi, during 5 years (2002-2006).The diagnostic was based on the clinical-biologic study and risk factors with febrile syndrome, mialgic syndrome, headache, meningial, liver and renal failure and hematological syndromes, with the serologic evidence of serotypes of leptospirosis.All the patients were serologic confirmed with leptospirosis. Leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with lever and renal failure.

The authors present the results of retrospective epidemiological, clinical and laboratory diagnosis on toxocariasis cases hospitalized in the Pediatric Diseases Clinic of Iaşi, between January 2005-June 2008.The study included a number of 228 children.Respiratory manifestations were present in 184 children: 105 boys (46.05%) and 79 girls (34.64%), with a slight advance of the rural environment (44.29%). The age distribution highlighted a predominance of 1-5 years of age (65.76%). Respiratory manifestations were fever, coughing, wheezing, asthma, infections of respiratory pathways, pneumonia. The distribution of toxocariasis in children patients in Moldavia, Romania, highlighted a predominance in Iaşi. The children with respiratory manifestations had hypereosinophilia associated with hyperleucocytosis. All the patients were serologically confirmed with toxocariasis. The children responded well to treatment with albendazole.

To evaluate the benefit of this early method of diagnosis of tuberculous meningitis, gamma-interferon levels comparatively in blood and cerebrospinal fluid (CSF).We have studied 50 patients with tuberculous meningitis admitted in the Clinic of Infectious Diseases Iaşi between 2006-2007, from the epidemiological, clinical, diagnosis and therapeutical points of view.Tuberculous meningitis was more frequent in males, with a mean ration of 2.5. The age of patients varied between 2 and 78 years of age, with a mean value of 30.5 years. 35.6% of patients were children. In 32 cases the meningeal infection was secondary, disseminated from a primary site, most frequently from the lungs (68,7%). The bacteriologic confirmation was through culture in 13.3%, with an average of 23.4 days of incubation. In whole blood the sensitivity Quantiferon TB Gold assay (QTF) was 78.57%. In CSF the specificity was higher than in blood (96.1 vs. 88.4%), having a positive prediction value over 90%. Antituberculous therapy prior to QTF testing had a negative impact, 50 to 6 cases having negative QTF results.The performance indicators of TB Gold Quantiferon Test in serum or CSF are high, being more sensitive and rapid than the direct exam of CSF or BK culture.

Erysipelothrix rhusiopathiae is a Gram-positive rod, carried by many domestic and pet animals and very resistant in the environmental habitat, causing an anthropo-zoonosis infection in humans. It can determine, most frequently, a skin infection and may cause also septic arthritis or systemic infection, usually associated with aortic endocarditis. Bacteremia without endocarditis is a very rare presentation, generally seen in immunocompromised patients. We report such an unexpected diagnosis in a 75-years old woman, with mitral regurgitation, who was investigated for a persistent febrile syndrome, with no evidence of vegetation on repeated echo examinations and no evidence of the entry portal and who recovered successfully from an E. rhusiopathiae bacteremia with Ampicillin iv. therapy for 14 days.

Leptospirosis is a zooantroponosis manifested as an infectious disease with a severe evolution, with liver and renal failure and hemorrhagic manifestation. The aim of this study was to present the clinico-biological investigation and the therapeutical aspects of 256 cases of leptospirosis admitted in the Infectious Diseases Hospital Iasi during 4 years (1998-2001). The diagnosis was based on the study of clinico-biological and therapeutical parameters (risk factors, fever, mialgia, headache, algic, eruptive, meningeal, hepatorenal, hemorrhagic syndromes with the serological evidence of the serotypes of leptospirosis); most of the cases were registered in 1998 (23% cases), in adults (31.2%) and male (75.22%). All the patients were serologic confirmed with leptospirosis (RAL and RFC), and L. icterohaemorhagiae was isolated most frequently. The standard anti-leptospirosis treatment was administered with favorable evolution; 6 deaths were registered from the severe forms of the disease. The leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with liver and renal failure.

The study of incidence, clinical manifestation and treatment of acute diarrhea with mixed etiology.Study of 48 patients with acute diarrhea with mixed etiology admitted in the Hospital of Infectious Diseases of Iaşi during 1995-1998.12 cases (24%) were mixed bacterial infections with the following microorganisms associations: Salmonella + Shigella (10 cazuri); Salmonella + Yersinia enterocolitica (1 case); Salmonella + Rotavirus (1 case). 16 cases (44%) had mixed digestive infections with parasites, in double or triple associations: Giardia intestinalis + Ascaris lumbricoides (10 cases); Giardia intestinalis + Ascaris lumbricoides + Entamoeba coli (1 case); Giardia intestinalis + Enterobius vermicularis (3 cases); Ascaris lumbricoides + Trichiuris trichiura (2 cases). The rest of 20 cases presented mixed infections with bacteria and parasites: Salmonella + Rotavirus + Giardia (2 cases), Salmonella + Shigella + Giardia intestinalis or Ascaris lumbricoides (6 cases), Salmonella + Giardia intestinalis (8 cases); Salmonella + Entamoeba coli (3 cases); Shigella + Trichiura trichiuris + Entamoeba coli (1 case). The majority was male patients from rural areas with age between 5 month and 56 years, the majority being children, 4 cases were found in immunosupressed patients. The clinical symptomatology was dominated by diarrheal syndrome (100%) and the diagnosis was established by clinical characters and confirmed by coproculture and parasitologic exam. The ethiological therapy was guided by antibiogram, in the majority of cases we used fluorochinolones (associated with ceftriaxone in severe cases), together with antiparasitic medications.In this study predominated the bacterial and parasitic infections, most frequently being isolated Salmonella, Shigella and Giardia intestinalis; the therapy associated fluorochinolones with antiparasitic medication.

To study the incidence, clinical manifestations and treatment of mumps virus meningitis.Study of 64 patients with mumps virus meningitis, admitted to the Clinic of Infectious Diseases of Iaşi during 1996-1999.The mumps virus meningitis had a high prevalence în 1998 (39%) most patients being males (62.5%) from the urban areas. 39.06% of cases were on the age group of 5-6 years old, 25% were in the age group 10-14 years old and 18.75% were adults patients. The clinical manifestation were dominated by headache (100%), fever (100%), vomiting (89%), photophobia (43.75%) and meningeal syndrome of contracture. The laboratory diagnosis was established by the cerebro-spinal fluid exam, together with the peripheric blood exam. The treatment was in all the cases with pathogenic (corticotherapy) and symptomatics with a very good evolution.All the cases with diagnosis mumps virus meningitis were well going, having good evolution and complete healing under symptomatic and pathogenic therapy.

Sleep quality is an important factor involved in students' learning process. Using different methods, actual studies suggest that complaints about sleep problems are common in young medical students. The aim of this study was to evaluate if is any relation between factors like medium and lifestyle among students of the University of Medicine and Pharmacy "Grigore T Popa" from Iaşi. The study group included 30 students (2 of them were excluded) who performed a polisomnography, self reported Epworth questionnaire and two weeks sleep diary. Coffee, energy drinks, green and black tea and alcohol intake were recorded. In our evaluation it was used sleep disturbance index (SDI), for sleep quality description. In those two weeks, the mean sleep hours was 7.8 (95% CI 7.6-8), greater in female than in male. The results suggest a significant correlation between psychical excitants and sleep fragmentation. More, excessive daytime somnolence declared is not in concordance with sleep quality observed in sleep recorded with polysomnography. It looks to be in correlation with bad sleep habits and psychical excitants intake.

Infections in the diabetic population can be severe and life threatning at least for two reasons: clinical signs are often torpid, masqued by chronical complications of diabetes leading to late recognition and medical adresability and also because of the inability to control established infection due to complex cell-mediated and humoral immunity deffects. The aim of the study was to evaluate the etiology, clinical features and outcome in diabetic patients with invazive disease.A retrospective study was conducted between January 2008 and December 2010 at The Clinical Hospital of Infectious Diseases Iaşi among 75 diabetic patients with sepsis of microbiologically confirmed etiology (positive cultures from normally sterile sites) and sepsis with clinically suspected etiology (positive cultures from pus). Cases with positive urocultures and coprocultures only, were excluded.From 75 diabetics, 56% were males, 90,7% being over 50 years. Severe cases of sepsis (33/75, 44%) were associated more often with insulin-treated diabetes than non-insulin treated group (40% vs. 4%, p0,005) probably because of multiple comorbidities associated as suggested by a high Charlson score (6,09 vs. 4,09, p0,05). There were 64 cases with confirmed etiology and 11 cases with clinically suspected etiology. Staphylococcus aureus and Escherichia coli were the most common agents isolated, being involved in 16 (21,3%) cases each, followed by coagulase negative Staphylococci (14/18,66%), Enterococcus spp.(6/8%), group B Streptococcus (3/4%), Streptococcus pneumoniae, Enterobacter spp., Salmonella spp. (2/2,66% each), Aerococcus viridans, Streptococcus equi, Klebsiella pneumoniae, Neisseria meningitidis, Sphyngomonas paucimobilis, Pseudomonas aeruginosa, Proteus mirabilis (1/1,33%). Multiple septic disseminations occured in 17(22,6%) cases and meningeal involvment was doccumented in 10(15,6%) cases. Meticillin resistance was noted in 53,3% for invasive isolates of S. aureus. Among 16 invazive strains of E. coli, 25% were resistant to 3rd generation cephalosporins, 17% to ciprofloxacin and 6,6% to aminoglycosides and colimycin. There were no E. coli strains resistant to imipenem, piperacillin-tazobactam and aztreonam. The mean mortality rate was 14,66%.The high level of resistance of S. aureus and E. coli to commonly used antibiotics and meningeal involvement imposes a multidisciplinary approach of the diabetic patient. Proper knowledge of the pathogers involved in the potential invazive diseases is an important tool for successful treatment with appropriate empirical broad-spectrum antimicrobial agents.

The main aim of the experiment is to prove the Paivio's theory about the concrete-abstract effect.A psychoverbal stimulation interface, created by us, was experimented as an IT extension of an EEG/EMG device dedicated for the human brain Evoked Potentials acquisitions (EPs) and reaction times techniques in reading mechanisms assessment.The shortest reaction time was achieved in tests at which the reading has no access to the meaning of words, for concrete word, in both hemisphere. But, in left hemisphere the reaction times for abstract words was shorter than for the abstract word in right hemisphere. EPs acquisition exhibits more negativity of N400 for concrete word and more reverberation of P650-N750 for abstract words.The difference in mean reaction times sustain the Paivio's theory and the difference in amplitude of N400, P650-N750 for concrete and abstract nouns show that the electric activities of brain are correlated in time and in amplitude with the same effort of processing the words. The psycho-verbal stimulation interface can be used as a medical research tool for studying and assessment the cognitive processes of reading, memory or learning using the endogenous visual event related potentials and the psychometric reaction times.

The study of incidence, clinical manifestations and prognosis of meningitis with anaerobic and non-fermentative bacteria.Retrospective study of 10 patients with severe forms of purulent meningitis admitted in the Hospital of Infectious Diseases of Iaşi, during 1.01.1990-31.12.1998.3 of them were diagnosed with etiology with polymicrobial flora and the rest had etiology with: Peptostreptococcus (2 cases), Acinetobacter calcoaceticus (4 cases), Eikenella corrodens (1 case). The majority were male sex (8 cases), and from rural area (9 cases). The age of patients ranged from 2.5 to 59 years (the majority being adults of group of age 50-60 years). The gate of entrance was: iatrogenic in the majority of cases (6 cases), posttraumatic (2 cases) and othogen (2 cases); 3 cases being with cerebrospinal fluid fistula and 8 patients being in coma. The factors associated with poor prognosis were: the immunosuppression (chronic etilism--4 cases; bronchopneumonia--2 cases, pulmonary cancer--1 case) and the presence of the focal neurological findings on the noser of illness. The diagnosis was established by clinical characters and confirmed by isolating germs from cerebrospinal fluid. The treatment was done at the beginning with first intervention antibiotic association with a high spectrum and then according to the antibiogramme. The evolution was severe even under treatment with 3 deaths, the mortality being of 30.0%.We wished to present these cases as a general remark on the severity of illness, generally appeared on a suppressed ground, together with the rarity of those germs implicated in the etiology of purulent meningitis.

Between 01.01.1997-31.12.1997 in the Infections Diseases Clinical Hospital of Iaşi were admitted 492 patients suffering from measles. The above mentioned number of patients represents 4.92% of all the patients (10097) who were admitted during this period of time. More than half of the patients (56.9%) are residents in suburban arias. Teen-agers and young adults (15-24 years) were involved in most of the cases, followed by new born babies (0-11 months). The clinical signs were prevalent minor and the atypical exanthema was found in 1/4 of all cases. The most frequent complications were pneumonia, bronchopneumonia and otitis media. Of all the patients, two children (average age 1-4 years) died.

Clinical, bacteriological and therapeutically study on iatrogenic staphylococcal meningitis.Retrospective analysis of 33 cases of iatrogenic staphylococcal meningitis admitted to the Hospital of Infectious Diseases of Iaşi in the interval 1988-1997.In the interval under study the recorded incidence was 1-5 cases per year. The predisposing factors were neurosurgical procedures for endocranial processes (12 cases), operated chronic otomastoiditis (11 cases), ventriculoatrial or peritoneal shunt (5 cases) and neurosurgical assessment (5 cases). The onset was slow, with persisting and mild headache persistence recurrence of fever, vomiting and convulsions followed by meningeal contracture and encephalitic phenomena. In 24 patients cerebrospinal fluid was typical for purulent meningitis. The causal agents were isolated in 25 cases being Staphylococcus aureus (20 cases) and Staphylococcus epidermidis sensitive to usual antistaphylococcal agents. Three therapeutically schemes were used the association cefotaxim î gentamycin proving to be the most effective vancomycin was required in but 2 cases. Three deaths were recorded.The symptoms of iatrogenic staphylococcal meningitis are mild marked by the underlying disease the most effective treatment being the association of cefotaxim with an aminoglycoside.

Infections in diabetic patient remains an important cause of morbidity and mortality, triggering and maintaining a prolonged metabolic imbalance. Emergence of extented spectrum beta-lactmase (ESBL) in Escherichia coli and Klebsiella pneumoniae is a major concern, because of the atypical manner infection acts in this group of imunodepressed patients and also for the limited therapeutic solutions. For this reason we have evaluated the profile of antimicrobial resistance of these pathogens in both diabetic and non diabetic patients.The aim of this study was to evaluate, in a retrospective case control study, the antibiotic susceptibility pattern in isolates of E. coli and Klebsiella spp. from different biological products in 49 diabetics and 150 non-diabetics admitted in The Clinical Hospital of Infectious Diseases Iaşi over a period of two years.Most of strains of E. coli and Klebsiella spp. ESBL positive were found in uroculture. Significant differences in E. coli resistance rate between diabetics and nondiabetics were noted for amoxicillin-clavulanic acid and ciprofloxacin (31,4% vs.13,98%, p=0,04, respectively 52,9% vs. 24,46%, p=0,004). More isolates of ESBL positive K. pneumoniae were found in diabetic patients (50% vs. 24%). Ciprofloxacin resistance of K. pneumoniae was significantly higher in diabetics (75% vs 39%; p=0,05). There was no resistance in E. coli and K. pneumoniae isolates to imipenem in the diabetic group.The high resistance rate to quinolones and 3rd generation cefalosporins limits their use for the treatment of Escherichia coli and K. pneumoniae infections. Other alternatives for empiric therapy in community and nosocomial-acquired infections in diabetic patient remains carbapenems, aminoglycosides and colimycin.

Acute gastroentritis is one of the most common diseases in humans, and continues to be a significant cause of morbidity worldwide.To determine the bacterial pathogens associated with gastroenteritis in patients admitted to the Iasi Infectious Diseases Hospital in the last ten years.A total of 40481 stool samples were examined using conventional methods.Bacteria were found in 7.36% of cases, and parasites in 9.64%; 83% of the cases were viral, micotic, or disbiotic. The bacterial etiology was dominated by Salmonella spp. (58.34%), Shigella spp. (27.08%), Yersinia enterocolitica 03 (8.53%), Campylobacter spp. (1.31%), other bacterial pathogens (EPEC, Aeromonas hydrophilla/caviae/sobria, Plesiomonas shigelloides, Bacillus cereus, Staphylococcus aureus, etc) being detected in 3.74% of the cases. Of the Salmonella species, group B (51.99%) followed by group D (45.23%) were most common. Shigella sonnei and Shigella flexneri were found in almost the same proportion (49.45% and 49.70%, respectively); Shigella boydii was isolated in only 0.85% of cases. The trend of gastroenteritis caused by bacterial pathogens is decreasing: from 355 cases in 2001 to 105 cases in 2010; three peaks have been recorded in 2002, 2005 (when Salmonella typhi was isolated in a patient), and 2008 (469, 409, and 252 cases, respectively). Bacterial gastroenteritis affected both sexes almost equally (122 males and 118 females). The most affected age groups were: 0 - 4 years, 15 - 24 years, 5 - 14 years and 25 - 39 years.Laboratory investigations are essential in determining the etiology of gastroenteritis. Its unpredictable incidence justifies the human and material efforts aimed at controlling the spread of potentially epidemic acute gastroenteritis.

We performed QuantiFERON-TB Gold in Tube (QFT-G) in blood and CSF at 40 children diagnosed with TB meningitis and at 39 children with non TB meningitis, admitted between October 2006 and December 2009.The CSF analyses were suggestive for TB at 27 patients and only 14 had positive culture. The sensitivity of QFT-G in CSF was 72.72% and 69.44% in blood; specificity 96.96% in CSF and 89.18% in blood; the positive predictive value was 96% in CSF and 86.2% in blood; negative predictive value was 78.04% in CSF and 75% in blood. The sensitivity of TST was 61.76% and specificity 82.05%. The sensitivity of the culture from CSF was only 35%. The sensitivity and specificity of QFT-G was higher than TST and culture and better in CSF than in blood.The determination of alpha-interferon in serum and CSF is useful diagnostic marker of tuberculosis who could improve the management of TB meningitis.

Bacterial meningitis is still an important topic for the infectious diseases specialist, due to it's high incidence, severity and it's high mortality rate.We retrospectively studied 679 patients diagnosed with community acquired bacterial meningitis in the Infectious Diseases Hospital Iaşi, Romania between 1998 and 2007.The annual number of admissions slightly decreased in the last years. Most patients were males (62.1%). Predisposing factors were present in 34.9% of cases. Seizures were described in 19.6% of cases, more frequent in children. The CSF was purulent only in 69.4% of patients, 29.6% of them receiving antibiotics prior to admission; the albumin level in the CSF of pneumococcal meningitis was higher than in other meningitis. The etiology was established in 51.6% of cases, more frequent in sucklings (68.1%). N. meningitidis was the most common cause of community acquired acute bacterial meningitis (CABM) (28.5%) followed by S. pneumoniae (14%). S. pneumoniae was susceptible to penicillin in 79% of cases. The mean mortality rate was 13.1%.Factors associated with a poor prognosis were: pneumococcal etiology, age over 60, and the presence of seizures or coma at admission.

Myocardial infarction is a rare condition in children. We present the case of a 14-year-old girl with known cardiac abnormalities admitted to our pediatric cardiology department with cough, cyanosis, low level of consciousness, and difficult breathing. Two days after her admission, she developed severe thoracic pain associated with tachycardia and agitation. The electrocardiogram revealed myocardial ischemia and then myocardial infarction with a rapid onset of cardiac arrest not responding to resuscitation techniques. Postmortem examination confirmed the diagnosis.

The aim of our study was to analyze clinical and biological characteristics of immunocompromised patients with staphylococcal sepsis and to compare with the same data in non-immunocompromised patients.The diagnosis of sepsis was made based on Bone criteria. MiniAPI system ID 32 STAPH was used for identification and antibiotic susceptibility was assessed by ATB STAPH method and by E-test for oxacillin and vancomycin.Among the 147 patients with Staphylococcus aureus sepsis--66.67% had concomitant immunosuppressive conditions (diabetes mellitus, liver diseases, renal failure, corticotherapy, etc). We have found a significant correlation between the immunosuppressed status and MRSA (methicillin-resistant Staphylococcus aureus) involvement (p = 0.0018) and also, between this group of patients and treatment failure (p = 0.0012).Because of the high rate of MRSA involvement in systemic infections in the Eastern region of Romania first intention treatment of patients with staphylococcal infections and conditions of immunosuppression must include antibiotics effective against methicillin-resistant strains.

We assessed clinical and microbiological characteristics of Staphylococcus aureus (SA) infections in hospitalized patients during a period of three years (October 2005 - October 2008) in the Clinic Hospital of Infectious Diseases Iaşi.The study included 169 patients with SA infections (sepsis, meningitis, skin infections and urinary tract infections). MiniAPI system ID 32 STAPH was used for identification and antibiotic susceptibility was assessed by ATB STAPH method and by E-test for oxacillin and vancomycin.The rate of methicillin resistance (MR) was 48%, all strains being susceptible to linezolid, vancomycin, teicoplanin. In our study MRSA was susceptible in approximately 94% of cases to clindamycin and cotrimoxazole. Infections were defined as nosocomial in 51% of patients with a rate of MR of 52% and community-acquired in 49% with a rate of MR of 23% (p = 0.001). Clinical profile was: localized infection in 41% of patients with MRSA and systemic infection (sepsis with at least one organ involvement or bacteremia) in 59% of patients with MRSA infections (p = 0.53). Initial treatment was inadequate in 46% of MRSA infections. One third of strains had MIC of vancomycin 2 mg/mL.The high level of methicillin resistance of S. aureus straints isolated from infections (48 %) justifies a particular approach of initial antistaphylococcal therapy.

The aim of the study was to investigate the particularities of the clinical manifestation and evolution of tuberculous meningitis at children.The study was made between January 2000 and December 2008 in Clinic of Infectious Diseases IaSi and Emergency County Hospital ,,Sf. Ioan cel Nou" Suceava on a group of 169 children with tuberculous meningitis.The majority (78.1%) of patients had poor socio-economic conditions and 22.4$ had a family TB contact. The onset of the symptoms was atypical in infants and small children with fever associated with digestive, neurological or pulmonary manifestations. The admission in hospital was delayed in 56.8% of patients and 39.05% had a severe general status with coma. The positive diagnosis was based on cytological and biochemical features of CSF, results of QuantilFERON. TB Gold, pulmonary images, family TB contact and evolution under anti-tuberculous therapy. We observed a high rate of complications represented by hydrocephaly (28.9%). 18 patients died (4 infants), the cause of dead being meningeal coma or complications.The diagnosis of tuberculous meningitis at children remains a problem because of the atypical clinical manifestation, the delay of initiating the therapy causing high mortality and frequent complications.

Omega-3 fatty acids are essential for human health, are crucial for the brain, body development and also in prevention of cardiovascular diseases.We used 60 male Wistar fats, weight 180 +/- 20 grams, divided into two study groups: normal control animals (M) and test animals (T) divided in groups I (N3-PUFA), II (ACC) and III (N3-PUFA and ACC). Administration of the substances was made for 36 weeks (nine months), after which the animals were evaluated and subsequently sacrificed for further biochemical analysis. As an evaluation method has been used multiple T maze labyrinth.Group I recorded a time maze percentage decrease from -4.26% to -33.88%. In group II we recorded a decrease time maze percentage from -5.37% to -34.28%. During the experiment, group III recorded a decrease time maze percentage from -5.1% to -32.33% at the end of the experiment. The control group evolution for the maze recorded a decrease in time maze percentage, reaching 17-18% at the end of the experiment.By improving the diet with polyunsaturated fatty acids increased exponentially cognitive performance compared with normal diet, low in these acids.