Treatment of anaerobic infection after caesarean section (case report)

Catedra chirurgie generală, USMF “Nicolae Testemiţanu”, Spitalul Clinic Municipal nr.1, Chişinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Femeile care au suportat operaţia cezariană prezintă un risc de la 5 la 20 ori mai mare pentru complicaţii infecţioase, faţă de cele care nasc pe cale naturală. Complicaţiile includ endometritele (20-85% din cazuri), infecţia plăgii (25%), bacteriemia, abcesele pelviene, şocul septic, fasciitele necrotizante şi tromboflebitele venelor pelviene. Principalele microorganisme responsabile pentru endometrite sunt bacilii aerobi gram-negativi (E.coli); bacilii anaerobi gram-negativi (Bacteroides sp. şi Gardnerella vaginalis); cocii aerobi gram-pozitivi (streptococii din Grupul B şi Grupul D); şi cocii anaerobi gram-pozitivi (Peptococcus sp. şi Peptostreptococcus sp). Pe parcursul travaliului şi a naşterii abdominale endometriumul şi cavitatea peritoneală sunt invariabil contaminate cu un număr mare de bacterii patogene aerobe şi anaerobe care prolifere ază în lichidul peritoneal postoperator sero-sangvin. Caz clinic: Este raportat cazul unei femei obeze (IMC=40) cu vârsta de 39 ani, care a fost supusă operaţiei cezariene la a 13-a naştere. În pofida indicaţiilor nu au fost administrate antibiotice în scop profilactic nici până, nici după intervenţie. Peste 2 zile bolnava a fost transferată în secţia de chirurgie datorită dehiscenţei şi infecţiei plăgii. S-a recurs la histerectomie totală. Analiza bacteriologică a pus în evidenţă prezenţa Enterobacter aerogenus, Enterococcus sp. şi a Staphylococcus aureus. Pe parcursul a 28 de zile au fost administrate antibiotice în conformitate cu sensibilitatea patogenilor, concomitent cu tratamentul local al plăgii. Vindecarea completa a fost atestată în ziua a 56-a. Concluzie: În grupul de risc este strict indicată antibiotico-profilaxia peri-cezariană.Introduction: Women who undergo caesarean section have a 5 to 20-fold greater risk of infectious complications than those after normal vaginal delivery. The complications include endometritis (20-85% of cases), wound infection (25%), bacteremia, pelvic abscess, septic shock, necrotizing fasciitis, and septic pelvic vein thrombophlebitis. The main microorganisms responsible for endometritis are aerobic gram-negative bacilli (E.coli); anaerobic gram-negative bacilli (Bacteroides sp. and Gardnerella vaginalis); aerobic gram-positive cocci (Group B and Group D streptococci); and anaerobic gram-positive cocci (Peptococcus sp. and Peptostreptococcus sp). During labor and abdominal delivery, the endometrium and peritoneal cavity invariably are contaminated with large numbers of highly pathogenic aerobic and anaerobic bacteria which are proliferating in the serosanguineous postoperative peritoneal fluid. Clinical case: We report a case of an obese (BMI=40) 39 years old woman who suffered a caesarean section at 13th delivery. In spite of indications, no prophylactic antibiotics where administrated nor before neither after intervention. After 2 days she was transferred to the Surgical Department due to wound dehiscence and infection. Total hysterectomy was performed. Bacteriological analysis identified presence of Enterobacter aerogenus, Enterococcus sp. and Staphylococcus aureus. There were administrated antibiotics according to sensibility of the pathogens for 28 days, along with local debridement of the wound. After 56 days of hospitalization complete healing was reported. Conclusion: It is strictly indicated to use prophylactic antibiotic administration peri-caesarean section in the risk group

Researches Regarding the Use of Non-conventional Actuators

The purpose of this article is to present relevant concepts about the study of electro-pneumatic circuits using fluidic muscle actuators. The fluidic muscle is a type of pneumatic actuator having an extensive history of technical applications in the biomechanical field since the 1955. After Introduction, the authors study two pneumatic circuits. In fact, the first pneumatic circuit in this paper has only one actuator (fluidic muscle 1-1), but the second pneumatic circuit has two actuators (fluidic muscles 2-1 and 2-2. Further on, the authors present two electro-pneumatic schematics, a simple electro-pneumatic circuit and another electro-pneumatic circuit with PLC (Programmable Logic Controller). This type of actuator is used in robotics, material handling, motion control, industrial field and other applications. The pneumatic and electro-pneumatic circuits given in this paper are made using FluidSim software from Festo. In this case, the fluidic muscles are only non-conventional actuators. However, in pneumatic installations as well as in electro-pneumatic installations, the non-conventional actuators have the following advantages: strength, compactness, reliability, low price, ease of assembly or disassembly from their circuits, etc. Of course, in practice are many types of fluidic muscles, which are used in electro-pneumatic installations