Aim: High-quality national representative data on obesity in Romanian children are needed to shape public health policies. To providea unified data landscape on national prevalence, trends and other factors associated with underweight, overweight, and obesity in Romanian children aged 6-19 years, across the last decade (2006-2015). Methods: Using a common protocol, we selected published and unpublished studies that measured Romanian children in schools between 2006 and 2015. Children's BMI was classified using the current WHO, IOTF, and CDC references. Results: 25,060 children from 8 Romanian counties were included in the analysis. The prevalence of underweight children was 5%/4.5%/8.5% (WHO/IOTF/CDC), while the prevalence of overweight (including obese) children was 28.3%/23%/23.2% (WHO/IOTF/CDC). The prevalence of overweight children did not change significantly over the last decade (chi-square test p = 0.6). Male gender (odds ratio (OR) 1.37; 95% CI 1.29-1.45, compared to female); prepubertal age (OR = 3.86; 95% CI 3.41-4.36,compared to postpubertal age), and urban environment (OR 1.12; 95% CI 1.01-1.26, compared to rural environment) had higher risk for overweight. Conclusion: While the prevalence of underweight children was low, almost one in four children in Romania was overweight or obese (according to WHO criteria) between 2006 and 2015. This prevalence remained relatively stable over the last decade. Male gender, prepubertal age, and urban environment, were the most relevant risk factors associated with overweight status in Romanian children.

Considering the growing interest in functional foods, the identification of the individual species of elements is of great importance in understanding specific nutraceutical properties. The present study aims to compare the dynamic of the elemental content (K, Na, Ca, Mg, Fe, Cu, Zn, Mn, Ni, and Se), total polyphenols, and antioxidant activity of Trifolium pratense L. and Medicago sativa L. sprouts in different germination stages. The elemental profile was established by atomic absorption spectroscopy after the microwave acid digestion of the samples, while total polyphenols and anti-radical activity were evaluated by UV-Vis spectroscopic methods. Phenolic compounds and anti-radical activity of both alfalfa and red clover sprouts varied with germination stages. Germination can significantly increase the anti-radical activity in the first 3 days of germination, followed by a decline in the following days. An increase in total polyphenols was noticed, starting from the second day of germination in both plant species. There were significant (p < 0.05) differences for Ca, Na, Fe, K, Zn, and Mg contents among the sprouts, depending on the germination stage and plant species. The calcium contents of alfalfa ranged between 200.74 µg/g DW (raw seeds) and 2765.31 µg/g DW (sprouted), while in red clover between 250.83 µg/g DW and 601.59 µg/g DW. Maximum selenium content in alfalfa sprouts, reached in the 3rd day of germination (11.42 µg/g DW), exceeded the maximum value measured in red clover (9.42 µg/g DW). The data were subject to statistical processing using analysis of variance (ANOVA), multivariate analysis (PCA) and hierarchical clustering analysis (HCA).

The Waste Management activity (WM) is an urban action becoming more and more important in the municipal economy. In many cities, this activity is linked to significant revenues from the selective waste collection services. Because the current economic situation requires an increasing efficiency and profitability in order to succeed in cutting the operational costs, and as an important part of revenue comes from this selective waste collection activity, the effectiveness must be improved. In the specific case of Galati (250 000 inhabitants) which is presented in this article, the WM activity has been redesigned. The main aspect is given by the successful implementation of the selective collecting waste management system in order to succeed in reaching the current economic commands. In this article we present results obtained after 122 days of monitoring. Our approach has certain elements of novelty. Based on the data records we studied the possibility of obtaining a mathematical model which would be able to describe the time evolution of the amount of waste deposited in the collecting points. The simplest mathematical model was investigated, basing on the fact that a neural network approaching was not possible. For this purpose, we applied a set of three different methods of identifying the mathematical model which corresponds to the most accurate assessments. In the final part, is presented the related algorithm and the results obtainable by using this approach. The used procedure is based on a dynamical optimization process considering a specific Dijgistra algorithm. In this way, it could be build dynamical maps by eliminating a series of points whose contribution are not important for that moment. Finally, are presented specific results based on this dynamical optimization process.

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Changing vector habitats due to climate change increase the risk of less common vector-borne diseases spreading to temperate areas. An example of such a disease is dirofilariasis. The present article is a case presentation of ocular dirofilariasis. The peculiarities of this case and its implications to public health are presented herein, in addition to a literature review of the epidemiological data regarding dirofilariasis in dogs and humans. A16-year-old adolescent, who had never travelled outside Galaţi County, was admitted to the hospital's pediatric department with conjunctival edema, foreign body perception, redness and local pain in the left eye. A parasitological exam identified Dirofilaria repens. The outcome of the condition was favorable. Although canine dirofilariasis is more often encountered by veterinary practices, only few human cases had hither to been reported in Romania, none in Galaţi County. A national Romanian prevalence study on dirofilariasis in animals is called for in order to improve the management of the disease, both in veterinary and human medicine.

Background: Efficient postoperative pain management, which is aimed at decreasing the risk of complications and drug-induced side effects, without affecting the quality of analgesia, is part of today's concept of enhanced recovery after surgery, that is, fast-track surgery. Study Question: The objective of this study was to determine whether effective management of acute postoperative pain was possible without opioids, while avoiding complications, drug-induced side effects, and suboptimal treatment. Introduction of metamizole, which has regained popularity, into a multimodal analgesia regimen was used, as opioids are not routinely administered. Study Design: The study was prospective, observational, unrandomized, and without the control group. Measures and Outcomes: This study was performed in a pediatric hospital with 300 beds and an average of 1700 annual surgical interventions. The study group comprised 378 patients aged 1–17 years, undergoing lower abdominal or limb surgery between June 2016 and June 2017. Children underwent subarachnoid anesthesia combined with intravenous sedation and received not routinely but on demand postoperative opioid analgesia. The pain was self-assessed by the pediatric patient or was assessed by the nurse using pain scores. Results: Metamizole proved to be safe, efficient, and very well tolerated by children. Multimodal analgesia using acetaminophen, nonsteroidal anti-inflammatory drug with metamizole for the treatment of moderate to severe pain in children undergoing surgery, required a single opioid dose in 292 patients (77.24%) of the 378 in this study. Conclusions: In pediatric patients undergoing surgery, subarachnoid anesthesia combined with intravenous sedation, multimodal analgesia that includes metamizole, and nonpharmacological complementary therapies in pain management enable avoidance or reduction of opioids to a single dose, without undertreatment. There is also a minimum of anesthesia, accelerated children's recovery and a rapid return to presurgical levels of function.

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Villous atrophy syndrome aetiology includes celiac disease, cow milk protein allergy, duodenitis, temporary gluten intolerance, food allergies (to other than cow milk), occasional giardiosis and secondary lactase deficits. This study endeavours to evaluate the incidence of celiac disease in villous atrophy syndrome, to determine optimal age for diagnosis and most frequent signs and symptoms that occur at the onset of the disease.The study group was made up of 112 children aged between 3 months and 7 years, which were hospitalised over a period of 2 years and exhibited characteristic symptoms, such as prolonged diarrhoea (lasting more than 3 weeks), underweight and/or arrested development, vomiting, lack of appetite, abdominal pains and bloating. All patients were investigated using serum tests for celiac disease and superior digestive endoscopy with duodenum biopsy. The correlation between histopathological aspects (Marsh classification) and clinical patient aspects, i.e. antitransglutaminase and antiendomisium antibody levels, were studied through quantitative correlations between antibody levels and lesion severity.Clinical manifestations of the malabsorbtion syndrome were caused, in order of frequency, to celiac disease, digestive intolerance to cow milk protein, secondary lactase deficits and postenteritic syndrome. Onset of the disease was in 59.33 % of cases before 1 year of age, and the evolution of the disease was classical in 75 % of cases, most frequently manifesting itself by chronic diarrhoea and underweight. In patients with celiac disease, villous atrophy (Marsh class III a-c) occurs in most underweight and chronic diarrhoea patients (70 % of cases) or in patients suffering from abdominal pains (60%). Over 60 % of patients diagnosed with celiac disease tested positive for at least one of two studied serum markers (antiendomisium and antitransglutaminase antibodies). All celiac disease sufferers who also had Marsh IIIc histological modifications were serum positive for at least one of the investigated serum antibodies. Marsh II histology patients were the fewest to yield serum positive results.In many studies in children, celiac disease was the most frequent cause of clinical manifestations characteristic of the malabsorbtion syndrome associated with villous atrophy histological modifications.Of the four diseases characterised by villous atrophy syndrome, celiac disease is most frequently accompanied by paraclinical modifications, which have important repercussions on the organism (anaemia, low iron and magnesium levels and bone growth retardation).