Background: Pain is one of the symptoms for which any man is willing not only to go to the doctor but also to resort to any means, including self-medication, to “get rid” of it. Self-medication is not only a current practice but also a public health problem, under the circumstances that it can influence the way in which a disease is diagnosed and/or treated in a timely manner, and, consequently, repercussions may occur on the cost of treatment, in the case of severe forms. Pain is a vital symptom, and the diminution until the disappearance of pain is a fundamental right of each individual; the analysis of ethical issues in the case of self-administration of analgesic medication has not been a major concern. Areas of Uncertainty: Understanding the problem is important to realize whether self-medicating for pain is a necessity or an abuse, and in this respect, we review scientific articles from international databases: PubMed and ProQuest. Data Sources: The study is based on the consultation of scientific articles from international databases—PubMed and ProQuest, the main keywords in the search being pain and self-medication, to which a stigma or public health is sequentially added. Results: Pain is becoming more and more a global problem and the extent of its spread can substantiate our assertion about pathology with pandemic impact. Under the pressure of patient associations, of the media, and of nonmedical authorities, the opinion about the need for a stoic approach to pain has long become an outdated theory, and chronic pain, beyond a multidimensional approach, is increasingly considered not only a useless element but also even a destructive one. Conclusions: Pain and self-medication must be addressed, including in medical practice, starting from their multidimensionality from the following perspectives: medicobiological, sociocultural, instructive-educational, legal-political, and especially ethical. They are not only individual health problems but also become, when connected with a stigma, a public health problem.
Background: Adjustment disorder requires therapeutic intervention because of its complications, which include a significant risk of suicide, but evidence-based therapeutic guidelines are not available. Areas of Uncertainty: The main problem is related to answer to the following question: What is the optimal therapeutic approach to adjustment disorder? In this respect we review all randomized controlled trials that aimed to investigate therapeutic interventions for adjustment disorder in adult populations. Data Sources: Comprehensive search of the electronic database PubMed (January 1980–June 2019). The review included clinical trials that aimed to investigate a psychological or pharmacological treatment for adjustment disorder in adult population and reported outcome data for therapeutic interventions. Results: The search identified 23 studies that fulfilled the inclusion criteria for this review. Pharmacotherapy interventions were the focus of 11 studies that used various medications and dosages including viloxazine, lormetazepam, S-adenosylmethionine, pivagabine, trazodone, clorazepate, etifoxine, lorazepam, diazepam, afobazole, and plant extracts (Kava–kava, Euphytose, and Ginkgo biloba) on a total number of 1020 patients. Psychotherapy interventions were identified in 12 studies that used mirror therapy, short-term dynamic psychotherapy, yoga meditation, body-mind-spirit technique, mindfulness, bibliotherapy (self-help manual), humor training, and cognitive behavioral therapy. Conclusions: Psychotherapy seems indicated for mildly symptomatic adjustment disorder. Given the fact that adjustment disorder with severe symptoms is associated with a high risk of suicidal ideation and suicide attempts, clinicians must consider the potential benefit of using psychotropic agents such as benzodiazepines, antidepressants, or etifoxine.
We chose to use a recently proposed four-step algorithm for the management of MDI-HTN. A 1-month follow-up program was established. Weekly visits were scheduled to elicit about side effects and measure blood pressure . Ambulatory blood pressure monitoring was performed after a month. The strategy was first to reuse medication from classes the patient was intolerant to, but in smaller doses and in combinations. Among same class members, we have chosen those with less adverse effects. Not all steps within the algorithm were followed since our patient did not need alternative formulation as liquid or transdermal ones. Anxiety medication was prescribed as nonlicensed antihypertensive medication. At the end of the follow-up month, blood pressure control was satisfactory, 24-hour ambulatory blood pressure monitoring was 135.5/83.0 mm Hg, and the patient did not claim any adverse drug reactions.
Introduction: Vaccination is a procedure through which a community can become actively immunized by the administration of a vaccine. In recent years, in Romania, there has been an anti-immunization “movement” induced by several anti-vaccinists, who have alleged that vaccination might have a detrimental effect on the community. The purpose of the study was to gather as much information as possible from rural people about the parents’ concerns about having their children vaccinated, to highlight how well-informed rural people are about vaccination, and also to show the importance of this prophylaxis- and even disease eradication method. Material and method: A pilot descriptive cross-disciplinary research study was conducted. It was performed on a group of 150 rural people. The data collection period was between 3 June 2021 and 19 July 2021. The research was created by applying a questionnaire used as a research tool, which included 31 questions to identify the issues related to the rural population’s opinions on immunization-related information and on what could be done to successfully cope with them. Results: The result analysis has shown that 75% of the study participants have information about vaccination and its benefits and that most people do not vaccinate their children because of a lack of relevant information. Conclusions: Following this study, we can conclude that the community’s level of confidence in vaccination is on the decline. Whether it’s the lack of information or the fear of possible side effects, most people are reluctant when it comes to vaccinating their children. Rezumat Introducere: Vaccinarea este un procedeu prin care comunitatea se poate imuniza activ prin administrarea unui vaccin. În ultimii ani, în România există o „mișcare” împotriva imunizării, indusă de mai mulți antivacciniști care au semnalat faptul că vaccinarea are o acțiune dăunătoare asupra comunității. Scopul studiului a fost de a culege cât mai multe informații de la persoane din mediul rural cu privire la nedumeririle pe care părinții le au înainte de a-și vaccina copiii, de a pune în evidență cât de informați sunt oamenii din mediul rural în ceea ce privește vaccinarea, dar și de a arăta importanța pe care o are această metodă de profilaxie și chiar eradicarea unei boli. Material și metodă: A fost realizat un studiu pilot de cercetare transversal de tip descriptiv. Acesta a fost efectuat pe un lot de 150 de persoane din mediu rural. Perioada de culegere a datelor a fost cuprinsă între 3 iunie 2021 și 19 iulie 2021. Cercetarea a fost creată prin aplicarea unui chestionar folosit ca instrument de cercetare, ce a cuprins 31 de întrebări, pentru a identifica aspectele legate de opinia populației din mediu rural privind informațiile deținute despre imunizare și despre ce s-ar putea face pentru a veni în întâmpinarea acestora. Rezultate: În urma analizării rezultatelor s-a constatat că participanții la studiu posedă informații legate de vaccinare și beneficiile ei într-o proporție de 75%, majoritatea oamenilor nu își vaccinează copiii din cauza lipsei insuficiente de informații. Concluzii: În urma studiului putem concluziona că nivelul încrederii comunităților privind vaccinarea este în scădere. Fie că este vorba de lipsa informațiilor, teama de posibilele reacții adverse, majoritatea persoanelor au o reținere atunci când trebuie să își vaccineze copiii.
Background: HIV-Stigma among infected patients is a real problem both globally and nationally. Despite the efforts of the authorities to inform the population through educational campaigns, HIV-positive patients experience various levels of stigma and self-stigmatization that contribute to the decrease of their adherence to antiretroviral therapy. Objective: Assessing the impact of stigmatization of HIV/AIDS patients as a premise for the development of mechanisms to reduce it. Methods: Based on the premise that society stigmatizes these patients due to insufficient information and personal fears, a study was carried out at the Faculty of Medicine in Brașov, between January and July 2021, which included 35 patients from the Clinical Hospital for Infectious Diseases in Brașov and 117 respondents from various areas of Brasov society. Results: The present study followed both the effects that stigmatization had on patients, but also the feedback of the Brasov community on stigmatizing attitudes. It was found that there are many issues that need to be corrected in terms of educating the population on HIV/AIDS (manifestations, transmission, and protection against the spread of HIV), especially on the concept of undetectable=untransmittable, so little known to the Romanian community, requiring debate, clarification, and improvement as outlined in the study. Conclusions: Open patient-community communication could mitigate the effects of stigma and increase social inclusion. Rezumat Introducere: Stigmatizarea pacienților cu HIV/SIDA reprezintă o problemă reală atât la nivel mondial cât și național. În ciuda eforturilor autorităților de informare a populației prin campanii educaționale, pacienții seropozitivi experimentează diverse nivele de stigmatizare și auto-stigmatizare care contribuie la scăderea aderenței acestora la terapia antiretrovirală, știut fiind că este imperios necesar ca pacienții să urmeze tratamentul specific pentru a împiedica transmiterea virusului. Obiectiv: Assessing the impact of stigmatization of HIV/AIDS patients as a premise for the development of mechanisms to reduce it. Material şi metodă: Pornind de la premisa că societatea stigmatizează acești pacienți datorită informării insuficiente și a temerilor personale, în cadrul Facultății de Medicină din Brașov a fost derulat în perioada ianuarie-iulie 2021 un studiu care a inclus 35 de pacienți din cadrul Spitalului Clinic de Boli Infecțioase din Brașov, și respectiv 117 respondenți din diverse arii ale societății brașovene. Rezultate: Studiul de față a urmărit atât efectele pe care le-a avut stigmatizarea asupra pacienților, dar și feedback-ul comunității brașovene privind atitudinile stigmatizante. S-a constatat că există foarte multe aspecte care trebuie corectate în ceea ce privește educația populației asupra HIV/SIDA (manifestările, modalitățile de transmitere și cele de protecție împotriva răspândirii HIV), în special asupra conceptului de nedetectabil=netransmisibil, atât de puțin cunoscut comunității românești actuale, necesitând dezbateri, clarificări și îmbunătățiri așa cum a reieșit din studiu. Concluzii: O comunicare deschisă pacient-comunitate ar putea atenua efectele stigmatului și ar crește gradul de incluziune socială
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