Sandra Alexiu - Academia.edu (original) (raw)

Papers by Sandra Alexiu

Population medicine, Apr 26, 2023

Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.

Medic.ro, Sep 18, 2017

Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patient... more Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patients and the identification of PAD most frequent risk factors in Romanian family medicine practices. Design and methods. An observational, cross-sectional, multicenter study that enrolled 800 patients between November 2010 and February 2011, from 40 family medicine practices across the country. Inclusion criteria were adult patients with of one or more risk factors for PAD. Patients were investigated for PAD by determining the ankle-brachial pressure index (ABPI) values; values of ABPI ≤0.9 were considered indicative for PAD. Results. Approximately 50% of patients had ABPI ≤ 0.9. They had an average age of aproximatelly 60 years old, and the most common risk factors were dyslipidemia and HTA. 33% of these patients were smokers, 33% were diagnosed with coronary heart disease and 19% with cerebrovascular disease. 56% of patients had signs of intermittent claudication, 43% had a low or absent peripheral pulse, 42% had skin modifications. Only 17% of these patients were previously diagnosed with PAD. Conclusions. Compared to previously prublished data indicating a PAD prevalence of approximately 29% in high risk patients, in Romania PAD prevalence was 50%. 75% of patients diagnosed with PAD were symptomatic, compared with 50% as communicated in similar studies in other countries. However, only 17% were diagnosed with PAD. Although PAD is an important predictive factor for cardiovascular events, this condition remains underdiagnosed and undertreated in Romania. Therefore, it becomes increasingly important to introduce a correct assessment methodology of patients at high risk of developing PAD by simple and easy-to-use ambulatory methods such as ABPI.

SNMF WEBSITE, 2014

The Romanian National Society of Family Medicine (SNMF) supports the development, implementation ... more The Romanian National Society of Family Medicine (SNMF) supports the development,
implementation and use of the patient Electronic Health Record in Romania (DES) and considers
this project a normal development in the context of progress and increased use of health
information systems.
At the same time, the Romanian National Society of Family Medicine is concerned about the lack
of clear legislation regarding the creation, use and storage of DES. In this context, SNMF supports
the adoption as soon as possible of the legal framework for the use of DES.
Finally, the Romanian National Society of Family Medicine considers it is essential to carry out a
cost-effectiveness analysis and a feasibility study for DES, or to publish them if they already exist.
The patient Electronic Health Record becomes functional only when interoperability between
healthcare providers is ensured, when they can access in real-time the relevant medical data, the
patient’s laboratory tests and their results, and when all these lead to the elimination of paperbased medical records.

npj Primary Care Respiratory Medicine, Jul 10, 2014

BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the pro... more BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). AIM: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. METHODS: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. RESULTS: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. CONCLUSIONS: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.

Medic.ro, Apr 20, 2017

In Romania there is an ongoing measles outbreak so that on 3.03.2017 there were recorded 3196 cas... more In Romania there is an ongoing measles outbreak so that on 3.03.2017 there were recorded 3196 cases and 16 confirmed deaths. Most cases were found in counties con­sidered at high risk but the epidemic occured also in low risk counties. In December 2016 and January 2017 actions were taken to limit the epidemic of measles but only 39% of all children in the age group 9-11 months were vac­cinated. The results are not in line with the expectations and there are discrepancies between counties. An analysis on causes of this outbreak and barriers which limit the im­ple­mentation of effective measures is necessary.

Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patient... more Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patients and the identification of PAD most frequent risk factors in Romanian family medicine practices. Design and methods. An observational, cross-sectional, multicenter study that enrolled 800 patients between November 2010 and February 2011, from 40 family medicine practices across the country. Inclusion criteria were adult patients with of one or more risk factors for PAD. Patients were investigated for PAD by determining the ankle-brachial pressure index (ABPI) values; values of ABPI ≤0.9 were considered indicative for PAD. Results. Approximately 50% of patients had ABPI ≤ 0.9. They had an average age of aproximatelly 60 years old, and the most common risk factors were dyslipidemia and HTA. 33% of these patients were smokers, 33% were diagnosed with coronary heart disease and 19% with cerebrovascular disease. 56% of patients had signs of intermittent claudication, 43% had a low or absent ...

Medic.ro

A quick scan of a few articles published in the last three years on the main international channe... more A quick scan of a few articles published in the last three years on the main international channels of medical com­munication on international antibiotic use statistical data uncovers a worrying growth, which explains the emergence of over resistant bacteria by increasing the antibiotic re­sis­tance of common germs that cause the main infections spread around the globe. Romania ranks first in Europe in terms of germ resistance to antimicrobials, as evidenced by data published by the World Health Organization (WHO) and the European Center for Communicable Di­­sease Control (ECDC). As the latest WHO data show, an­­ti­­bio­­tic resistance is one of the biggest threats to global health, food security and current development, it can na­tu­ral­ly affect anyone, of any age, in any country, but mi­­suse of antibiotics in humans and animals speeds up the process. An increasing number of infections – such as pneu­­monia, tuberculosis, gonorrhea and salmonellosis – are increasingly difficult t...

npj Primary Care Respiratory Medicine, 2014

BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the pro... more BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). AIM: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. METHODS: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. RESULTS: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. CONCLUSIONS: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.

npj Primary Care Respiratory Medicine, 2014

Population medicine, Apr 26, 2023

Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.

Medic.ro, Sep 18, 2017

Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patient... more Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patients and the identification of PAD most frequent risk factors in Romanian family medicine practices. Design and methods. An observational, cross-sectional, multicenter study that enrolled 800 patients between November 2010 and February 2011, from 40 family medicine practices across the country. Inclusion criteria were adult patients with of one or more risk factors for PAD. Patients were investigated for PAD by determining the ankle-brachial pressure index (ABPI) values; values of ABPI ≤0.9 were considered indicative for PAD. Results. Approximately 50% of patients had ABPI ≤ 0.9. They had an average age of aproximatelly 60 years old, and the most common risk factors were dyslipidemia and HTA. 33% of these patients were smokers, 33% were diagnosed with coronary heart disease and 19% with cerebrovascular disease. 56% of patients had signs of intermittent claudication, 43% had a low or absent peripheral pulse, 42% had skin modifications. Only 17% of these patients were previously diagnosed with PAD. Conclusions. Compared to previously prublished data indicating a PAD prevalence of approximately 29% in high risk patients, in Romania PAD prevalence was 50%. 75% of patients diagnosed with PAD were symptomatic, compared with 50% as communicated in similar studies in other countries. However, only 17% were diagnosed with PAD. Although PAD is an important predictive factor for cardiovascular events, this condition remains underdiagnosed and undertreated in Romania. Therefore, it becomes increasingly important to introduce a correct assessment methodology of patients at high risk of developing PAD by simple and easy-to-use ambulatory methods such as ABPI.

SNMF WEBSITE, 2014

The Romanian National Society of Family Medicine (SNMF) supports the development, implementation ... more The Romanian National Society of Family Medicine (SNMF) supports the development,
implementation and use of the patient Electronic Health Record in Romania (DES) and considers
this project a normal development in the context of progress and increased use of health
information systems.
At the same time, the Romanian National Society of Family Medicine is concerned about the lack
of clear legislation regarding the creation, use and storage of DES. In this context, SNMF supports
the adoption as soon as possible of the legal framework for the use of DES.
Finally, the Romanian National Society of Family Medicine considers it is essential to carry out a
cost-effectiveness analysis and a feasibility study for DES, or to publish them if they already exist.
The patient Electronic Health Record becomes functional only when interoperability between
healthcare providers is ensured, when they can access in real-time the relevant medical data, the
patient’s laboratory tests and their results, and when all these lead to the elimination of paperbased medical records.

npj Primary Care Respiratory Medicine, Jul 10, 2014

BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the pro... more BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). AIM: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. METHODS: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. RESULTS: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. CONCLUSIONS: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.

Medic.ro, Apr 20, 2017

In Romania there is an ongoing measles outbreak so that on 3.03.2017 there were recorded 3196 cas... more In Romania there is an ongoing measles outbreak so that on 3.03.2017 there were recorded 3196 cases and 16 confirmed deaths. Most cases were found in counties con­sidered at high risk but the epidemic occured also in low risk counties. In December 2016 and January 2017 actions were taken to limit the epidemic of measles but only 39% of all children in the age group 9-11 months were vac­cinated. The results are not in line with the expectations and there are discrepancies between counties. An analysis on causes of this outbreak and barriers which limit the im­ple­mentation of effective measures is necessary.

Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patient... more Study objectives. Estimation of Peripheral Arterial Disease (PAD) prevalence in high risk patients and the identification of PAD most frequent risk factors in Romanian family medicine practices. Design and methods. An observational, cross-sectional, multicenter study that enrolled 800 patients between November 2010 and February 2011, from 40 family medicine practices across the country. Inclusion criteria were adult patients with of one or more risk factors for PAD. Patients were investigated for PAD by determining the ankle-brachial pressure index (ABPI) values; values of ABPI ≤0.9 were considered indicative for PAD. Results. Approximately 50% of patients had ABPI ≤ 0.9. They had an average age of aproximatelly 60 years old, and the most common risk factors were dyslipidemia and HTA. 33% of these patients were smokers, 33% were diagnosed with coronary heart disease and 19% with cerebrovascular disease. 56% of patients had signs of intermittent claudication, 43% had a low or absent ...

Medic.ro

A quick scan of a few articles published in the last three years on the main international channe... more A quick scan of a few articles published in the last three years on the main international channels of medical com­munication on international antibiotic use statistical data uncovers a worrying growth, which explains the emergence of over resistant bacteria by increasing the antibiotic re­sis­tance of common germs that cause the main infections spread around the globe. Romania ranks first in Europe in terms of germ resistance to antimicrobials, as evidenced by data published by the World Health Organization (WHO) and the European Center for Communicable Di­­sease Control (ECDC). As the latest WHO data show, an­­ti­­bio­­tic resistance is one of the biggest threats to global health, food security and current development, it can na­tu­ral­ly affect anyone, of any age, in any country, but mi­­suse of antibiotics in humans and animals speeds up the process. An increasing number of infections – such as pneu­­monia, tuberculosis, gonorrhea and salmonellosis – are increasingly difficult t...

npj Primary Care Respiratory Medicine, 2014

BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the pro... more BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). AIM: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. METHODS: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. RESULTS: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. CONCLUSIONS: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.

npj Primary Care Respiratory Medicine, 2014