Background: To evaluate changes in smoke free rules in the foster care system after the implementation of the Romanian national clean air law. Methods: A repeated cross-sectional, self-administered questionnaire among foster care employees (n = 599) was conducted in 58 foster care homes during 2014 (n = 295) and 51 homes during 2016 (n = 304). We estimated the absolute difference in the proportion of employees who stated that smoke free rules existed before and after national clean air legislation. Results: There was an absolute increase in 4 of 5 smoke free measures after the law: bans on non-cigarette tobacco products (n = 169 to 206, +10.6%), non-smoking on premises for adults (n = 142 to 202, +18.3%), and for children (n = 201 to 239, +10.3%), and no smoking in cars to transport children (n = 194 to 227, +9%). There was a significant increase in the perception of outdoor bans that prohibit employees from smoking on foster care home premises (AOR 2.24, 95% CI 1.14–4.38). The increase in the perception of indoor smoking bans did not change. Conclusion: The national law may have had a spillover influence by strengthening smoke free rules in unregulated spaces. Nonetheless, foster care home rules could be further enhanced, particularly in cars that transport children.

We discovered a rare pathology described in adulthood, followed by the development of a long asymptomatic evolution, which underlined the importance of multidisciplinary collaboration. We present the case of a 62-year-old female smoker patient, with a known previous medical history of chronic ischemic heart disease, hypertension, chronic obstructive pulmonary disease (COPD), gastric ulcer and gastritis. The patient was rushed to the emergency room (ER) with acute respiratory failure, chest discomfort, ankle and facial edema and a chest X-ray showing a right lower pulmonary lobe consolidation, with an alarming ischemic electrocardiogram (ECG) modification without increasing myocardial cytolysis indicators. This led our medical team to investigate a possible cardiovascular event that might have been in development. After immediate admission, thoracic computer tomography (CT) imaging was carried out, which found a Morgagni diaphragmatic hernia, containing adipose tissue and the hepatic flexure of the colon with approximate dimensions of 50/100 mm. We faced differential diagnostic problems. We knew the subject’s existing cardiac and chronic respiratory tract pathologies from their previous medical history; therefore, multiple investigations and check-ups were carried out. A chest CT and surgery intervention were needed to resolve this case. Subsequently, the acute respiratory failure and alarming ischemic ECG modification disappeared.

The constantly and intensely changing modern society has a negative influence on the the general population�s health status. Risk factors being deeply inserted in the structure of the modern society can hardly be influenced and corrected. The aim of the study was the lifestyle- and diet-related comparison of two distinct adult populations from Romania: Bacau and Tirgu Mures. Material and methods: We evaluated the dietary habits, alcohol consumption and physical activity by a complex, validated questionnaire. Body mass index was also determined. The adult population from Tirgu Mures numbered 352 subjects, who were compared to the adults from Bacau, numbering 231 individuals. The considered threshold of significance was 0.05. Body mass index is over the normal range in more than 2/3 of the subjects. The overweight occurrence was 37.95%. The majority of the subjects (77.5%) has regular daily exercise (30 minutes or more). Daily alcohol consumption was present in 42.42% of the cases. Dietary habits were also analyzed: 61.9% of the subjects consume breakfast daily, and 46.94% of them consumes snacks between meals 2-3 times per week. A statistical difference could be observed regarding the frequency of breakfast consumption and body mass index (p-0.042): 2/3 of the studied adults from Tirgu Mures who eat breakfast sometimes having their body mass index over 25 kg/m2. Regarding physical activity a significant difference could be observed in case of those who responded rarely or never (p-0.027) (76.0% of Mures county with this response vs. only 24.0% in Bacau). The frequency of alcohol consumption is higher in Tirgu Mures and surroundings in case of once or several times per week consumption (p-0.005). Instructional and educational interventions targeting the development of healthier lifestyle habits in general population are worthy and needed to reduce the risk factors associated with the development of cardiovascular and metabolic diseases and reducing the burden upon the society of these diseases.