Aspects of diagnostics and treatment of deep vein thrombosis

Spitalul Clinic Municipal, Bălţi, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Tromboza venoasă profundă este varietatea de tromboză acută, în care trombul se formează practic în lumenul vascular sănătos, aderă slab sau nu se fixează de peretele venei, ușor poate fi rupt și transportat de torentul sanguin. Scopul lucrării este de a pune în evidenţă metodele de diagnostic și tratament ale trombozei venoase profunde. Materiale şi metode: Studiul reprezintă experienţa clinică în tratamentul trombozei venoase profunde la 67 de bonavi în perioada anilor 1996-2005. Femei au fost 28 (42%), bărbaţi – 39 (58%). Rata persoanelor apte de muncă a constituit 65%. Rezultate: Pacienţii au fost supuși unui examen clinic, instrumental și de laborator, paralel cu tratamentul. Tratamentul a inclus anticoagulante (cu masă moleculară mică – nadroparina), antiagregante. Aprecierea eficacităţii tratamentului s-a efectuat în baza datelor clinice și examinării Doppler. Criteriile clinice ale eficacităţii tratamentului le-am considerat următoarele: (1) atenuarea edemului membrului afectat; (2) scăderea intensităţii durerii; (3) lipsa complicaţiilor trombembolice. Angioscanarea duplex indică evoluţia procesului trombotic, gradul de recanalizare a venei afectate. Concluzii: Pacienţii cu tromboză venoasă profundă necesită un examen complex. Examenul Doppler constituie o metodă sigură de diagnostic și de urmărire a eficacităţii tratamentului. Tratamentul complex permite evitarea complicaţiilor trombembolice și include neapărat anticoagulante directe, antiagregante.Introduction: Deep vein thrombosis represents the specific type of acute thrombosis, which is formed within generally unaffected vascular lumen, with poor adherence of the thrombus to the venous wall that is associated with increased risk of thrombus fragmentation and consequent embolization. The purpose of study is to highlight the methods of diagnosis and treatment of deep vein thrombosis. Material and methods: The study reflects the clinical experience in the treatment of deep vein thrombosis in 67 patients during the years 1996-2005. There were 28 (42%) female and 39 (58%) male patients. The rate of persons in working age was 65%. Results: The patients were supposed to the clinical, instrumental examination and laboratory tests simultaneously with the treatment. The treatment protocol included anticoagulants (with lower molecular weight – nadroparine), antithrombotics. The estimation of treatment efficiency was carried out on the basis of clinical and Doppler examination. The following criteria were considered as indicators of treatment efficacy: (1) decreasing edema of the affected leg; (2) diminishing of pain; (3) absence of thromboembolism. Venous duplex ultrasound indicates the evolution of the thrombotic process and degree of recanalization of the affected vein. Conclusions: The patients with deep vein thrombosis require a complex examination. The Doppler ultrasound represents the basic method of diagnosis and follow-up of the treatment efficacy. The complex treatment permits to avoid the thromboembolic complications and obligatory includes direct anticoagulants and antithrombotics

Diagrammatic analysis of the Hubbard model:Stationary property of the thermodynamic potential

Diagrammatic approach proposed many years ago for strong correlated Hubbard model is developed for analyzing of the thermodynamic potential properties. The new exact relation between such renormalized quantities as thermodynamic potential, one-particle propagator and correlation function is established. This relation contains additional integration of the one-particle propagator by the auxiliary constant. The vacuum skeleton diagrams constructed from irreducible Green's functions and tunneling propagator lines are determined and special functional is introduced. The properties of such functional are investigated and its relation to the thermodynamic potential is established. The stationary properties of this functional with respect to first order changing of the correlation function is demonstrated and as a consequence the stationary properties of the thermodynamic potential is proved.Comment: 6 pages, 4 figure

Căile aeriene dificile în chirurgia maxilo-facială (Caz clinic)

Catedra Anesteziologie şi Reanimatologie Nr 1 „Valeriu Ghereg”, USMF „Nicolae Testemiţanu”, Centrul Naţional Ştiinţifico-Practic de Medicină de Urgenţă, Chişinău, Moldova, Catedra Chirurgie Orală şi Maxilo-Facială, USMF „Nicolae Testemiţanu”, Congresul II Internaţional al Societăţii Anesteziologie Reanimatologie din Republica Moldova 27-30 august 2009Confruntarea cu un pacient neventilat şi neintubat reprezintă o încercare serioasă pentru anestezist. Identificarea pacienţilor cu risc de intubare dificilă este un pas esenţial în examenul preanestezic ce poate reduce morbiditatea şi mortalitatea legată de căile aeriene dificile. Aplicarea anesteziei generale, a sedării intravenoase induce depresie respiratorie, care necesită asistenţă respiratorie cu protejarea căilor aeriene. Intubarea dificilă este definită ca necesitatea de a efectua mai mult de 3 încercări de intubare, sau mai mult de 10 minute, utilizând laringoscopie clasică. Laringoscopia dificilă este atunci, când nu este posibil de a vedea nici o porţiune a corzilor vocale prin laringoscopie clasică. În prezicerea căilor aeriene dificile sunt importante următoarele: anamnesticul, examinarea, măsurările, sistemele de scoruri, eşecurile

Current approaches in maxillary sinus traumatic and infectious injuries

Catedra Chirurgie Oro-Maxilo-Facială USMF „Nicolae Testemiţanu”This article represents a retrospective study that comprises statistical data according to traumatic and infectious lesions of the maxilary sinus, patients repartition by gender, place, attendance, aetiology, treatment, that were recorded during 2008 year in Republican Center of Oro-Maxilo-Facial Surgery from Chisinau. In this study contemporary diagnosis and treatment methods with traumatic and infectious lesions of maxillary sinus are presented. Acest articol reprezinta un studiu retrospectiv ce cuprinde date statistice referitoare la leziunile traumatice şi infecţioase ale sinusului maxilar, repartizarea bolnavilor dupa sex, localitate, adresabilitate, etiolodie, tratament, ce au fost înregistraţi pe parcursul anului 2008 în cadrul Centrului Republican de Chirurgie Oro-Maxilo-Facială din Chişinău. În lucrarea dată sunt prezentate metode contemporane de diagnostic şi tratament a bolnavilor cu leziuni traumatice şi infecţioase ale sinusului maxilar

Immobilization methods in the treatment of the patient with zygomatic complex associated trauma

Catedra de chirurgie oro-maxilo-facială, Catedra de chirurgie oro-maxilo-facială şi Protetică dentară, FPM, USMF ”Nicolae Testemiţanu”Aeschylus fracture of the zygomatic complex in the clinic of Oral and Maxillofacial Surgery from Chisinau often is fixed via osteosynthesis methods as one of the safest methods and more perfect. Immobilization with Kirschner brooches are used in exceptional cases (single cases). Endooral access and temporally immobilization of the fractured fragments permit an aesthetic recovery of the patient with trauma of the zygomatic complex. Fractura eschiloasă a complexului zigomatic în Clinica de Chirurgie OMF din Chişinău mai des se fixează prin osteosinteză fiind una din metodele cele mai sigure şi cele mai perfecte. Imobilizarea cu broşa Kirschner sunt utilizate în cazuri excepţionale(cazuri unice) rar. Accesul endobucal şi temporal de imobilizare a fragmentelor fracturate permite recuperarea estetică a bolnavului cu traumatism al complexului zigomatic

A European study on decellularized homografts for pulmonary valve replacement: initial results from the prospective ESPOIR Trial and ESPOIR Registry data\u2020

OBJECTIVES: Decellularized pulmonary homografts (DPH) have shown excellent results for pulmonary valve replacement. However, controlled multicentre studies are lacking to date.METHODS: Prospective European multicentre trial evaluating DPH for pulmonary valve replacement. Matched comparison of DPH to bovine jugular vein (BJV) conduits and cryopreserved homografts (CH) considering patient age, type of heart defect and previous procedures.RESULTS: In total, 121 patients (59 female) were prospectively enrolled (August 2014-December 2016), age 21.3 +/- 14.4 years, DPH diameter 24.4 +/- 2.8 mm. No adverse events occurred with respect to surgical handling; there were 2 early deaths (30 + 59 years) due to myocardial failure after multi-valve procedures and no late mortality (1.7% mortality). After a mean follow-up of 2.2 +/- 0.6 years, the primary efficacy end points mean peak gradient (16.1 +/- 12.1 mmHg) and regurgitation (mean 0.25 +/- 0.48, grade 0-3) were excellent. One reoperation was required for recurrent subvalvular stenosis caused by a pericardial patch and 1 balloon dilatation was performed on a previously stented LPA. 100% follow-up for DPH patients operated before or outside the trial (n = 114) included in the ESPOIR Registry, age 16.6 +/- 10.4 years, diameter 24.1 +/- 4.2 mm, follow-up 5.1 +/- 3.0 years. The combined DPH cohort, n = 235, comprising both Trial and Registry data showed significantly better freedom from explantation (DPH 96.7 +/- 2.1%, CH 84.4 +/- 3.2%, P = 0.029 and BJV 82.7 +/- 3.2%, P = 0.012) and less structural valve degeneration at 10 years when matched to CH, n = 235 and BJV, n = 235 (DPH 61.4 +/- 6.6%, CH 39.9 +/- 4.4%, n.s., BJV 47.5 +/- 4.5%, P = 0.029).CONCLUSIONS: Initial results of the prospective multicentre ESPOIR Trial showed DPH to be safe and efficient. Current DPH results including Registry data were superior to BJV and CH.Thoracic Surger

Evaluation of Suppressed Mite Reproduction (SMR) Reveals Potential for Varroa Resistance in European Honey Bees (Apis melliferaL.)

Simple Summary The miteVarroa destructorrepresents a great threat to honey bees and the beekeeping industry. The opportunity to select and breed honey bees that are naturally able to fight the mite stands a sustainable solution. This can be achieved by evaluation of the failure of mite reproduction (SMR, suppressed mite reproduction). We conducted a large European experiment to assess the SMR trait in different populations of honey bees spread over 13 different countries, and representing different honey bee populations. The first goal was to standardize and validate the SMR evaluation method, and then to compare the SMR trait between the different populations. Our results indicate that it is necessary to examine at least 35 brood cells infested by a single mite to reliably estimate the SMR score of any given colony. Several colonies from our dataset display high SMR scores, indicating that this trait is present within the European honey bee populations. No major differences could be identified between countries for a given population, or between populations in different countries. This study shows the potential to increase selection efforts to breedV. destructorhoney bee resistant populations. In the fight against theVarroa destructormite, selective breeding of honey bee (Apis melliferaL.) populations that are resistant to the parasitic mite stands as a sustainable solution. Selection initiatives indicate that using the suppressed mite reproduction (SMR) trait as a selection criterion is a suitable tool to breed such resistant bee populations. We conducted a large European experiment to evaluate the SMR trait in different populations of honey bees spread over 13 different countries, and representing different honey bee genotypes with their local mite parasites. The first goal was to standardize and validate the SMR evaluation method, and then to compare the SMR trait between the different populations. Simulation results indicate that it is necessary to examine at least 35 single-infested cells to reliably estimate the SMR score of any given colony. Several colonies from our dataset display high SMR scores indicating that this trait is present within the European honey bee populations. The trait is highly variable between colonies and some countries, but no major differences could be identified between countries for a given genotype, or between genotypes in different countries. This study shows the potential to increase selective breeding efforts ofV. destructorresistant populations

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Thoracic Surger