Surgery in postoperator alkaline desease

Clinica de Chirurgie Generală şi Esofagiană, Spitalul Clinic “Sfânta Maria” Bucureşti, România, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Introducere: Se analizează retrospectiv experienţa clinicii pe 30 de ani (1981-2010) privind diversia duodenală totală Y-Roux (DDT) în tratamentul bolii alcaline de reflux postoperator(BARP). Materiale şi metodă, rezultate: Din 89 de pacienţi cu gastrojejunostomie Y-Roux după rezecţie gastrică distală cu diverse indicaţii, am selecţionat 29 de pacienţi la care procedeul s-a folosit în tratamentul BARP. Am exclus 9 cazuri cu DDT pentru patologie primară de reflux alcalin. În 20 cazuri DDT a fost practicată ca o modalitate reconstructivă pe “stomac operat”: degastrogastrectomie sau conversie a montajului anastomotic preexistent (la bolnavi cu 1-3 operaţii în antecedente, cu tulburări severe de motilitate). Se constată o scădere a numărului de cazuri în ultimii ani. La 9 pacienţi DDT a fost utilizată ca intenţie curativă antireflux după chirurgia biliară:colecistectomie ± coledocoduodenostomie, constatând creşterea numărului de cazuri în ultima perioadă. Criteriile de indicaţie chirurgicală: clinice, radiologice, endoscopice, histologice au selecţionat pentru intervenţie cazurile severe. Se prezintă particularităţile tehnice ca şi consecinţele morfofuncţionale ale DDT. Rezultatele imediate sunt foarte bune: morbiditate minimă (o reintervenţie precoce pentru ocluzie digestivă înaltă) şi mortalitate postoperatorie zero. Rezultatele la distanţă –evaluate clinic, radiologic, endoscopic şi histologic- arată o ameliorare postoperatorie certă, cu excepţia anumitor forme histologice. Concluzii: Incidenţa BARP după chirurgia gastrică a scăzut, prin scăderea drastică a indicaţiei operatorii pentru boala ulceroasă; în schimb creşte relativ incidenţa acestei entităţi după chirurgia biliară. DDT este o procedură eficientă dar de rezervă, indicată în cazuri bine selecţionate. Se constată o ameliorare postoperatorie certa clinică, endoscopică şi histologică, cu excepţia gastritei atrofice şi a metaplaziei intestinale, care se ameliorează în mică măsură.Introduction. We analyzed the experience of the Clinic on past 30 years (1981-2010) regarding total duodenal diversion (TDD) with Roux- en- Y gastrectomy for postoperator alkaline reflux disease (PARD). Materials and method, results: Among 89 patients presenting Y-Roux gastrojejunostomy after gastric distal resection for various indications, we selected 29 patients in which the procedure was used as treatment of PARD. We excluded 9 patients with TDD for primary alkaline reflux disease. In 20 cases TDD was used as a reconstructive procedure on “operated stomach” : degastrogastrectomy or conversion of the existing anastomotic assembly (at patients with history of 1-3 gastric operations, with severe motility disorders). It is ascertained a decrease in the number of such cases in recent years. At another 9 patients TDD was used as an antireflux cure after biliary surgery: colecistectomy ± choledocoduodenostomy, noting the increase number of such cases lately. The criteria for surgery indication: clinicals, radiologycals, endoscopicals, histologicals selected for intervention severe cases. There are presentated techniques particularities and morfofunctional consequences of TDD. Immediate results were very good: minimal morbidity ( one early reintervention for acute digestive occlusion) and no postoperator mortality. Long time results – clinical, radiological, endoscopic and histological evaluated- showed a certain postoperator improvement, excepting some definite histological forms. Conclusions: PARD incidence after gastric surgery has decreased through drastically decrease of surgical indication for patients with gastroduodenal ulcer; after biliar surgery. TDD is an efficient procedure but as a backup, being indicated only in cases very carefully selected. It is observed a definite clinical, endoscopic and histological postoperator improvement excepting atrophic gastritis which is less improved

THE INCIDENCE OF POTATO VIRUS Y (NECROTIC STRAINS) IN SEED POTATO GROWN IN SEVERAL ROMANIAN COUNTIES (PRELIMINARY STUDIES)

Protective measures of culture against Potato Virus Y necrotic strains (PVYN) infections, diagnosis and control of this pathogen play an important role in potato seed production technology and multiplication. Also, the choice of resistant varieties to the PVYN infection could be one of the measures recommended for farmers and producers. Surveys during 2 years (2014, 2015), in five main seed potato growing areas of Romania (Brasov, Covasna, Harghita, Cluj, Suceava), for 10 varieties (Christian, Roclas., Riviera, Carrera, Bellarosa, Jelly, Desiree, Red Fantasy, Hermes and Red Lady), revelead significant differences in PVYN incidence.The tests confirmed the PVYN presence in all the regions, with high prevalence of this virus especially for the cultivars Hermes and Carrera and very low spread for for the cultivars the cultivars the cultivars the cultivars the cultivars the cultivars Riviera and Christian

Inflation Inequality in Europe

We analyze cross-household inflation dispersion in Europe using fictitious monthly inflation rates for several household categories (grouped according to income levels, household size, socio-economic status, age) for the period from 1997 to 2008. Our analysis is carried out on a panel of 23 up to 27 household-specific inflation rates per country for 15 countries. In the first part of the paper, we employ time series and related non-stationary panel approaches to shed light on cross-country differences in inflation inequality with respect to the number of driving forces in the panel. In particular, we focus on the degree of persistence of the household-specific inflation rates and their the adjustment behaviour towards the inflation rate of a representative household. In the second part of the paper, we pool over the full sample of all countries and test if and by how much certain household categories across Europe are more prone to significant inflation differentials and significant differences in the volatility of inflation. Furthermore we search for the presence of clusters with respect to inflation susceptibility. On the national level, we find evidence for the existence of one main driving factor driving the non-stationarity of the panel and evidence for a single co-integration vector. Persistence of deviations, however, is high, and the adjustment speed towards the representative household is low. Even if there is no concern about a long-run stable distribution, at least in the short- to medium run deviations tend to last. On the European level, we find small but significant differences (mainly along income levels), we can separate 5 clusters and two main driving forces for the differences in the overall panel. All in all, even if differences are relatively small, they are not negligible and persistent enough to represent a serious matter of debate for economic and social policy

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Model for screening of resonant magnetic perturbations by plasma in a realistic tokamak geometry and its impact on divertor strike points

This work addresses the question of the relation between strike-point splitting and magnetic stochasticity at the edge of a poloidally diverted tokamak in the presence of externally imposed magnetic perturbations. More specifically, ad-hoc helical current sheets are introduced in order to mimic a hypothetical screening of the external resonant magnetic perturbations by the plasma. These current sheets, which suppress magnetic islands, are found to reduce the amount of splitting expected at the target, which suggests that screening effects should be observable experimentally. Multiple screening current sheets reinforce each other, i.e. less current relative to the case of only one current sheet is required to screen the perturbation.Comment: Accepted in the Proceedings of the 19th International Conference on Plasma Surface Interactions, to be published in Journal of Nuclear Materials. Version 2: minor formatting and text improvements, more results mentioned in the conclusion and abstrac