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Carmen Maria SALAVASTRU

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Articles signed on MÆDICA, JCM:

Dermatological Emergencies in a State Hospital in Bucharest

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MÆDICA - a Journal of Clinical Medicine | Vol. 13, nr. 4, 2018
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Dermatological Emergencies in a State Hospital in Bucharest

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ABSTRACT

Background: Dermato-venereology, a highly ranked medical specialty, is one of the top five career choices of medical school graduates in Romania. This specialty includes a vast palette of pathologies and is confronted with various types of emergencies. Health care policy makers refuse to acknowledge such cases and frame dermatology as an exclusive out-patient specialty. Over the past years, in Romania and other European countries, the health care system in Dermato-venereology has suffered important administrative changes. Our aim was to study the behavior and medical road map of patients with severe dermatological disorders throughout these changes.
Material and methods: A retrospective, analytical, comparative study was conducted in a University Department of Dermato-venereology which analyzed the medical activity in two different time periods, February-June 2011 (T1) and February-June 2015 (T2). Data were collected from the Dermatology Consultation Room’s registry book of the Hospital archive and was analyzed using Microsoft Office Excel 2010.
Outcomes: During T1 there were 696 emergency cases, whereas in T2 the administrative changes and relocation of the Dermatology Department impeded patients’ access and therefore, the total number of emergencies dropped to 163. The most frequent pathologies were urticaria and angioedema. There was also an increase in the number of pediatric patients throughout these time periods.
Conclusions: Administrative changes in state owned hospitals from Romania resulted in a significant decrease in the total number of patients accessing the dermatological units, with immediate effects on the diminishing specialized cutaneous care and long term effects on medical teaching.
Keywords: dermatological emergencies, inpatients, outpatients, health care policies

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Recommended Strategies for Epidermolysis Bullosa Management in Romania

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MÆDICA - a Journal of Clinical Medicine | Vol. 8 (11), no. 2 2013

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Recommended Strategies for Epidermolysis Bullosa Management in Romania

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ABSTRACT

Background: There are 72 families with epidermolysis bullosa (EB) in Romania. Since 2012 a National Program for the treatment of these patients is run by the Ministry of Health.

The objectives of the strategies for EB patients are to optimize the management (diagnosis, treatment, monitoring) and to provide actual information on classification and patho-physiology which dictate the course of the disease.

Methods: An international expert panel of specialists produced by consensus the recommendations for the management of EB cases in Romania taking into account the local possibilities. Patient association proposals were included. A review of the literature was performed to up-date the information.

Outcomes: A strategy for diagnosis, treatment and follow-up of the patients with EB was elaborated in clear steps. Pharmacological treatments and wound care indications are provided together with a useful score for patient evaluation.

Conclusion: These recommended strategies are allowing dermatologists to generate an individualized care plan for patients with EB.

Keywords: epidermolysis bullosa therapy, epidermolysis bullosa monitoring, dressings, wound care

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Epidemiological Aspects of Genital Warts in Romania – a 2012 Retrospective Survey

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MÆDICA - a Journal of Clinical Medicine | Vol. 9, nr. 2, 2014

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Epidemiological Aspects of Genital Warts in Romania – a 2012 Retrospective Survey

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ABSTRACT

Objectives: Genital infection with human papillomavirus (HPV) has become one of the most frequently viral sexually transmitted diseases. The infection may remain asymptomatic, may take the form of external genital warts and may give raise to cervical cancers. The aim of this study was to assess the frequency of the patients with genital warts addressing to five tertiary referral dermato-venereological units in Romania (where patients from several counties are referred) and to compare the results with the out-patient data reported by all Romanian hospitals.

Material and methods: Data regarding patients with external genital warts who addressed to the hospital emergency rooms, in five tertiary referral dermato-venerological units in Romania (Bucharest, Timisoara, Craiova, Constanta, Târgu-Mures) were collected for the year 2012. For comparison there have been used data collected by the National School of Public Health, Management and Professional Development, during the same year.

Outcomes: Data reported at national level in 2012 included 952 patients (731 women and 221 men) with 26 males under 20 years of age and 251 female patients in the age group 0-20 years. In the overall population (males and females combined) the total number of genital warts cases registered at the hospital emergency rooms in the five centers, in the year 2012, was 266 patients (119 men and 147 women) with 4 girls under 14 years of age and 6 male patients in the age group 0-14 years.

Conclusions: The high prevalence of the infection with HPV, the costs of treatment and the psychological impact prove that prevention of the disease is the most important step for decreasing the incidence of this disease. General measures for patients awareness regarding the disease and its complications need to be completed with the recommendation for vaccination. A closer monitoring of patients would provide information for a strategic national approach leading to a better outcome.

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