Гомеопатическое лечение предменструального синдрома у подростков

USMF „Nicolae Testemiţanu”, Catedra Obstetrică şi Ginecologie FECMFThis article provides the use of the homeopathic treatment of premenstrual syndrome in adolescents. In this study participated 25 adolescent girls with an average age of 15,5 ± 1,1years. The patients with PMS administered Guna - PMS for 2-3days until the advent syndrome and all menstruation, from 20 drops 2 times a day. It was found that during treatment with GunaPMS, the first month of treatment began with the advent of pain syndrome, which began after 15 min the pains have decreased considerably from prescribing to disappear completely in 2 hours in 17 (68,0 ± 0,1%) patients, and 5 (20,0 ± 0,9%) patients were assigned 10 drops Guna - PMS, and then the pain disappeared.Резюме. В данной статье предложено применение гомеопатического лечения предменструального синдрома у подростков. Принимали участие 25 девушек-подростков, средний возраст которых 15,5 ± 1,1 лет. Девушкам за 2-3 дня до появления синдрома назначали по 20 капель Guna – PMS, 2 раза в день за 2 дня до менструации. Было установлено, что на фоне лечения Guna-PMS в первый месяц лечения отмечено уменьшением интенсивности болевого синдрома, который начался после 15 мин. от назначения препарата. Полное исчезновение болевого синдрома отмечено у 17 (68,0±0,1%) пациенток через 2 часа, а 5 (20,0±0,9%) пациенток возникла необходимость назначения еще 10 кап. Guna – PMS, после чего исчезли боли

Профилактика врожденных аномалий развития. Факторы риска. Диагностика и медицинская практика

Department of Obstetrics and Gynecology, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaIn this work, interrelations about deficiencies of vitamins and microelements in apiaries congenital malformations were analyzed. Utilization of this substance is optimal in preventing congenital malformations. Using the risk factors is the first step in suspected cases of congenital malformations. It is very important to confirm or infer congenital malformations, because the optimal gestational age for completed gestation in our country is 21 weeks and 6 days.В настоящей работе приводится систематический анализ взаимосвязи между дефицитом витаминов (фолиeвая кислота) и микроэлементов (йод, цинк) и возникновением врожденных аномалий развития. А также, показаны факторы, определяющие группы риска, при этом даются диагностические шаги, которые помогают определить наличие врожденных аномалий развития до 21 недель беременности и 6 дней

Восстановлениe фертильности у пациенток с трубно-перитонеальным бесплодием после лапароскопической коррекции и комплексных реабилитационных мероприятий

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Catedra Obstetrică și ginecologieThe present work is dedicated to a major problem in modern gynecology – tubal peritoneal infertility in women with anterior surgical operations. The obtained results demonstrated that tubal peritoneal infertility in women with anterior laparotomies is determined by the presence of one (45,7%) or more (54,3%) surgical operations in their history, in combination with PID (59,8%), medical or spontaneous abortions (46,8%) that lead to 1st degree adherence process in 32,2% cases, 2nd degree – in 46,4% cases and 3rd degree – in 21,4% cases P (t) = 0,95 ). For the first time two techniques for the diagnostically and surgical laparoscopies were elaborated in dependence of postsurgical scare localisation. After the basically laparoscopic operation, at the level of tissue lysis, a medicine with regenerative and cytoprotective effects – Regesan – was applied. This medicine provides the prevention of new adherences formation and positively influences the restore of tubal function. The established benefits of the medicine Regesan offers a new strategy for practical implementation for the rehabilitation after endoscopical correction of tubal-peritoneal infertility in patients after anterior surgery. This method induced an increase in fertility restore up to 50,5%.Исследованиe посвящено изучению актуальной проблеме в гинекологии – трубно-перитонеальному бесплодию. Результаты данного исследования установили, что трубно-перитонеальное бесплодие обусловлено перенессенными хирургическими операциями, одной (45,7%) или нескольких (54,3%), комбинированными с ВЗПО (59,8%), медицинскими или самопроизвольными абортами, которые привели к образованию спаечного процесса I степени в 32,2 %, II степени в 46,4 % и Ш степени в 21,4 % случаев P (t) = 0,95 ). На основе многостороннего анализа различных взаимосвязанных и взаимозависимых показателей была разработана комплексная программа реабилитационных мероприятий больным пациеткам с трубно- перитонеальным бесплодием после лапароскопической хирургической коррекции. Предложенная и внедренная в практику программа реабилитационных мероприятий позволила увеличить эффективность комплексного лечения перитонеального бесплодия которая привела к восстановлению фертильности в 50,5%

Carotid paragangliomas: case report and imaging review

Background: Presentation of case reviews depicting the imaging characteristics of carotid paragangliomas, associated with a thorough analysis of the anatomical morphological features and the current therapeutic strategies.Materials and methods: We present the cases of 3 patients diagnosed with carotid paragangliomas in our clinic, illustrating diagnostic imaging elements by computer tomography (CT) and magnetic resonance imaging (MRI), but also the postoperative aspect of the carotid system, with respective anatomical, clinical and surgical considerations.Results: The imaging aspect of the carotid paragangliomas is characterised by a mass of soft tissue with intense contrast enhancement and with “salt and pepper” MRI appearance on conventional spin-echo sequences. The postoperative evolution of the patients included in the article was favourable, without any perioperative complications or signs of local tumour recurrence.Conclusions: Carotid paragangliomas are rare, often asymptomatic tumours, but with potential for increased malignancy, which raises the need for good knowledge of the cervical region pathology as well as the features of neuroendocrine tumours. CT and MRI examinations are essential for diagnosis, staging and, implicitly, for establishing the therapeutic strategy

Real Data Analysis and Efficiency of the TEA Mantova Casale (Italy) Variable-speed Pumping Station

AbstractVariable speed pumps (VSPs) are widely used in water distribution systems (WDSs). They can increase the efficiency of the system and reduce the energy consumptions, when the functioning conditions move away from those used for the design. Affinity laws allow to model the characteristic curve of VSPs, in terms of dimensionless flow, head and power. Efficiency of the VSPs can also be predicted, although the effects of the variation in the rotation speed can be questioned. In this paper, the experimental data acquired by TeaAcque at the Mantova Casale pumping station are interpreted by means of the dimensionless equations derived by the affinity laws. The measured “wire to water” efficiency of the system is compared to the theoretical one

Инфекции мочевыводящих путей в период беременности

USMF „Nicolae Testemiţanu”, Catedra Obstetrică şi Ginecologie FECMFBackground: Urinary tract infections(UTIs) are the most common medical complications of pregnancy, reaching about 10% of all pregnancies and may have an increased incidence in pregnant because anatomical and physiological changes during pregnancy facilitate the development of ITU. The importance of urinary infection in pregnant is the result of pregnancy complications pathology that causes. The goal of the study was to develop particularities of development of acute pyelonephritis and ITU infection in pregnancy, birth, and the postpartum period. Methods: The retrospective study was analyzed step by step for 137 patients. Recorded data included: age; live anamnesis, somatic and gynecological anamnesis. Physical examination. Instrumental examination - ultrasound examination. Laboratory investigations – uroculture, urinalysis, general analysis of blood biochemical analysis of blood. Statistic analyses are presented as mean±SD unless otherwise stated. Results: Evolution complicate pregnancy in women with UTIs: risk of giving premature birth imminence - 62.32% cases; early rupture of the amniotic membranes and premature birth, pre-eclampsy - 25.38%; IUGR, intrauterine fetal hypoxia - 12.40%cases. The birth „per vias naturalis” went in 87.6% of cases, and in 12.4% of cases pregnancy end cesarean section, after emergency obstetric indications. The birth was complicated by early rupture of amniotic membrane in 51.83% cases, intrauterine fetus acute hypoxia - 4.38%, discoordination birth - 43.79% of cases. The septic complications as puerperal endometritis developed in 40.14 % and acute exacerbation of pyelonephritis cases in the first three weeks safer birth were found in 2014.6% cases.Актуальность: Инфекции мочевыводящих путей (ИМП) являются одними из наиболее распространенных медицинских осложнений беременности, достигая около 10% всех беременностей из-за анатомических и физиологических изменений во время беременности. Важность ИМП у беременных является осложнения беременности, которые наступают на фоне этой патологии. Цель исследования заключалась определение особенности течения острого пиелонефрита на фоне беременности и определение влияния ИМП на течение беременности, родов и послеродового периода. Методы: в данном ретроспективном исследовании было проанализировано 137 пациентов: возраст; анамнез, соматический и гинекологический анамнез. Физическое и акушерское обследование. Инструментальное обследование - УЗИ. Лабораторные исследования: общий анализ мочи, общий анализ крови, биохимический анализ крови, посев мочи с чувствительностью к антибиотикам. Статистический анализ – определение среднего значения, как среднее ± SD. Значимость различий изменений от исходных перемен были протестированы с использованием парных образцов критерий Стьюдента, уровень значимости был установлен р<0,05. Результаты: беременность у исследованных пациенток с ИМП осложнились в 62,32% случаях угрозой прерывания беременности; в 25.38% случаев преждевременным разливом околоплодных вод и преждевременных родов, преэклампсия в 12.40 % случаях, ЗВУР плода, внутриутробной гипоксией плода. Беременность закончилась естественными родами в 87,6% случаев и кесаревым сечением по ургентным акушерских показаниям в 12,4% случаев. Роды осложнились преждевременным разливом околоплодных вод в 51.83% случаев, различные формы дискоординированных родов в 43.79 % случаев. На протяжении 3 недель после родов диагностирован послеродовый эндометрит в 40,14% и обострение пиелонефрита в 14,6% случаев

Surgical treatment of biliary tract malformations in children

Clinica Chirurgie şi Ortopedie Pediatrică, UMF „Gr.T.Popa”, Departamentul Anatomie Patologică, Spitalul Clinic de Urgenţe pentru Copii “Sfânta Maria”, Iaşi, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Rezumat: Tratamentul chirurgical al colestazei neonatale este cel mai bine ilustrat în două condiţii patologice particulare: atrezia de căi biliare şi chistul congenital de coledoc. A trecut aproximativ un secol de la prima tentativă de tratament chirurgical al colestazei la copil. Etiologia şi patologia acestor două condiţii rămân în continuare în mare masură o enigmă. Prima intervenţie chirurgicală specifică dedicată corecţiei atreziei biliare a fost efectuată de Morio Kasai în anul 1959, la Universitatea Sendai. Actualmente, tratamentul chirurgical atât al atreziei, cât şi al chistului congenital de coledoc sunt bine definite: portoenterostomia Kasai, respectiv excizia chistului congenital de coledoc şi refacerea circuitului digestiv prin hepaticoenteroanastomoză pe ansă în Y a la Roux. Din păcate, rezultatele mai puțin favorabile ale portoenterostomiei obligă la transplant hepatic ca ultimă soluţie pentru creşterea supravieţuirii la distanţă a acestor pacienţi. Actuala prezentare este o trecere în revistă a definirii termenilor referitori la obstacolul în scurgerea biliară determinând colestaza, a modalităţilor de diagnostic şi tratament accesibile autorilor, expunerea experienţei personale privind managementul acestor cazuri.Summary: Surgical treatment of neonatal cholestasis is best illustrated in two particular pathologic conditions: biliary atresia and congenital choledochal cyst. Almost a century passed since the first attempts of treating children’s cholestasis were undergone. The ethiology and pathology of these conditions were also poorly understood. The first surgical intervention specifically designed for the correction of biliary atresia was described by Morio Kasai in 1959.In the present time, the surgical treatment of both biliary atresia and congenital choledochal dilatation are well established: Kasai’s portoenterostomy and, accordingly, cyst excision and Roux-en-Y hepaticojejunostomy. Unfortunately, the overall poor results after portoenterostomy make liver transplantation an ultimate and mandatory solution for the long-term survival of the patients. This paper aims to define the terms regarding biliary outflow obstruction causing cholestasis, different diagnostic and therapeutical modalities accesible to the autors, exposing the personal experience in the management of congenital biliary tract malformations

Нарушения менструального цикла у молодых пациенток с метаболическим синдромом

USMF “Nicolae Testemiţanu”, Catedra Obstetrică şi ginecologie nr. 2Summary. As a result of the study, data was obtained proving the links between the pathogenesis of menstrual and reproductive disorders and metabolic syndrome in young patients. It was found that the initially reduced level of E2 and increased E1 in blood plasma in this category of patients causes the increased secretion of GnRH, which, in its turn, increases the sensitivity of receptors to gonadotropic pituitary cells. As a result of the increased production of LH by adenohypophysis increases disrupting the ratio of LH / FSH more than 1, followed by hypersecretion of androgens by the ovarian cells with their subsequent hypertrophy. The relative decrease of FSH level leads to a decrease of aromatase secretion, converting androgens to estrogens, and a secondary decrease in the level of E2 and anovulation. There is a pathological vicious circle. Clinically, it is manifested by hypomenstrual syndrome, infertility, and aggravation of MS severity.В результате исследования были получены данные о звеньях патогенеза нарушений менструальной и репродуктивной функций у пациенток с метаболическим cиндромом. Было обнаружено, что изначально сниженный уровень Е2 плазмы крови на фоне повышенного Е1 у данной категории пациенток обуславливает увеличение выброса ГРГ, который, в свою очередь, повышает чувствительность гонадотропных клеток гипофиза к этому гормону. В результате этого увеличивается продукция ЛГ аденогипофизом, нарушая соотношение ЛГ/ФСГ более 1, что приводит к гиперсекреции андрогенов тека-клетками яичников с их последующей гипертрофией. Относительное снижение уровня ФСГ приводит к снижению секреции ароматаз, превращающих андрогены в эстрогены и вторичному снижению уровня Е2 и ановуляции. Возникает патологический порочный круг. Клинически это проявляется гипоменструальным синдромом, бесплодием и усугублением тяжести МС

Laparoscopic treatment for perforated duodenal ulcer

Clinica de Chirurgie 2, UMF “Victor Babeș” Timișoara, Clinica de Chirurgie, UMF ”Carol Davila”, București, Clinica de Chirurgie 2, UMF ”Grigore T Popa”, Iași, Clinica de Chirurgie 2, Facultatea de Medicină, Universitatea ”Ovidius”, Constanța, Clinica de Chirurgie 2, Facultatea de Medicina, Sibiu, Clinica de Chirurgie 1, UMF ”Iuliu Hațieganu”, Cluj- Napoca, Departamentul de Chirurgie I, Facultatea de Medicină, UMF Craiova, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Acest studiu retrospectiv evaluează rezultatele tratamentului laparoscopic în ulcerul duodenal perforat și este realizat în 7 spitale cu experiență în chirurgia laparoscopica din România. Material și metode: Între anii 2006 și 2013, 297 pacienți (48 femei, 249 bărbați) cu vârste cuprinse între 18 și 77 ani au fost supuși intervenției chirurgicale laparoscopice pentru ulcer duodenal perforat, cu utilizarea a 3 (61%), 4 (29%) sau 5 (10%) trocare. Șaizeci și doi (21%) dintre pacienți au prezentat o formă ușoară, 190 (64,1%) au prezentat o formă moderată și 45 (14,9%) o formă severă de peritonită. Procedurile utilizate au fost: sutura simplă – 118 (39,8%) pacienți, sutura cu epiplonoplastie – 176 (59,5%), doar epiplonoplastie – 1 (0,3%) pacient, excizie și sutură – 1 (0,3%) pacient. Rezultate: Durata intervențiilor a fost între 30 și 120 minute, cu o medie de 65 minute. Mortalitatea a fost nulă. Complicații: infecții parietale – 3 (1%), fistule duodenale – 3 (1%), abcese abdominale – 2 (0,6%), hemoragii digestive – 1 (0,3%) și stenoza duodenală – 1 (0,3%). Durata medie de spitalizare – 5,5 zile. În comparație cu tehnica clasica, pacienții au necesitat mai puține analgetice și antibiotice, cu 80% mai puține pansamente și au avut cu 70% mai puține infecții parietale în evoluția postoperatorie. Concluzii: Tratamentul laparoscopic pentru ulcerul duodenal perforat, este recomandat chiar și în cazurile cu peritonită severă, evoluția postoperatorie fiind cu mai puține complicații și cu o recuperare mai rapidă fața de procedura clasică. Aceast abord poate fi considerat “standard de aur” în tratamentul ulcerului duodenal perforat.Introduction: This retrospective study evaluates results of the laparoscopic treatment of perforated duodenal ulcer obtained in 7 centers with experience in laparoscopic surgery from Romania. Material and methods: A total of 297 (48 women and 249 men) patients with perforated duodenal ulcer underwent laparoscopic intervention between 2006 and 2013, with ages 18 to 77 years. Three (61%), 4 (29%) or 5 (10%) trocars were used. In 62 patients (21%) was diagnosed mild form of peritonitis, in 190 (64.1%) – moderate and in 45 (14.9%) – severe peritonitis. Types of repair used in this study: simple suture – 118 (39.8%) patients, suture with omental patch – 176 (59.5%), only sutured omental patch – 1 (0.3%), excision and suture – 1 (0.3%) patient. Results: Operation time was between 30 and 120 min, with average of 65 min. Mortality rate was zero. Complications: parietal infections – 3 (1%), duodenal fistula – 3 (1%), intraabdominal abscesses – 2 (0.6%), digestive bleeding – 1 (0.3%) and duodenal stenosis – 1 (0.3%). Average length of hospital stay – 5.5 days. Patients treated using laparoscopic technique needed less analgesics, antibiotics, 80% less dressing procedures and had 70% less surgical site infections in comparison to traditional operation. Conclusions: Laparoscopic treatment of perforated duodenal ulcer can be recommended even for patients with severe peritonitis. This treatment is associated with fewer complications and more rapid recovery than traditional intervention. Laparoscopic repair can be considered “gold standard” in the treatment of perforated duodenal ulcer

Transplantul hepatic ortotopic de la donator decedat la adult. Experienţa Centrului de Chirurgie Generală şi transplant hepatic Fundeni

Studiul de faţă analizează experienţa Centrului de Chirurgie Generală şi Transplant Hepatic din Institutul Clinic Fundeni în transplantul hepatic ortotopic cu ficat întreg de la donator decedat la adult (THO), din aprilie 2000 până în aprilie 2006. În această perioadă au fost realizate 45 de THO – 20 femei şi 25 de bărbaţi, cu vârste cuprinse între 19-57 de ani (medie de 45 ani).Indicaţiile pentru transplantare au fost: ciroză VHB – 11, ciroză VHB VHD – 6, ciroză VHC – 13 (2 cu hepatocarcinom), ciroză VHB VHC – 2, ciroză VHB VHD etanol – 1, ciroză biliară primitivă – 5, boala Wilson – 2, ciroză toxic-nutriţională – 2, ciroza toxică non-alcoolică – 1, ciroză autoimună – 1, colangită sclerogenă primitivă – 1. Cu trei excepţii, la care s-a folosit tehnica clasică de transplantare, ficatul a fost grefat după tehnica Belghiti. Complicaţiile postoperatorii locale au survenit la 19 bolnavi (42,22%), iar generale la 19 (42,22%); complicaţiile tardive au fost înregistrate la 20 pacienţi (44,44%), iar recidiva bolii la 7 pacienţi (15,55%). Mortalitatea intraoperatorie şi postoperatorie imediată a fost de 6,66% (3 din 45 pacienţi). La peste 30 de zile de la TH, au decedat alţi cinci pacienţi (11,11%). Patru pacienţi (8,88%) au decedat la distanţă de momentul transplantului prin boală venoocluzivă, prin cancer bronho-pulmonar şi prin infarct miocardic -2. Patruzeci si doi de pacienţi au supravieţuit perioadei postoperatorii (93,33%) şi 33 peste un an (73,33%). THO reprezintă metoda principală de transplantare hepatică, cu o morbiditate şi mortalitate acceptabile