The elements of pathology and physiology of microsurgical flaps

Clinica de Chirurgie Plastică și Microchirurgie Reconstructivă, USMF “Nicolae Testemițanu”, Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Transferul microchirurgical la prima vedere, pe lîngă cursul de dezvoltare extrem de rapid al nanomedicinei, s-ar părea că rezolvă livrarea țesuturilor pentru plastia și reconstrucția zonelor afectate ale corpului uman. În realitate, direcția acestui vector nu este suficient elucidată și la moment rămîn a fi discutate semnele de întrebare, care apar pe marginea acestui subiect. Scopul: Interpretarea corectă a concepțiilor modificărilor care au loc în lambou, în baza cărora ulterior vom putea stabili un algoritm de supraveghere și de tratament bine elucidat și funcționabil. Material și metode: Au fost studiate 112 surse de specialitate care reflectă starea țesuturilor umane în anumite situații critice, inclusiv în lambouri. Rezultate: Chirurgia lambourilor este însoțită de trauma chirurgicală, iar transferul de țesuturi este urmat de leziuni ischemice de reperfuzie, ceea ce poate compromite tot rezultatul intervenției. Este acceptat faptul că leziunea de reperfuzie este un proces inflamator modulat de mecanisme complexe de semnalizare, care în cele din urmă duce la moartea celulară și afectarea lamboului. Restabilirea fluxului sanguin este esențială pentru supraviețuirea lamboului, cu toate acestea, paradoxul este că reperfuzia produce un prejudiciu ischemic prin numeroase căi inflamatorii. Concluzie: Blocajul acut al fluxului sanguin, fără depistarea de curînd și tratarea activă, poate urma cu acțiune sistemică sub forma insuficienței poliorganice și moarte.Introduction: The microsurgical transfer, besides the extremely rapid development of nanomedicine, seems that solves and offers solutions pertaining to the supply of tissues for the plasty and reconstruction of affected areas of the human body. In fact, the direction of this vector isn’t fully elucidated and at this moment remains to be discussed the questions which appear on this subject. Purpose: Correct interpretation of the concept of changes which take place in the flap, on the basis of which, later we’ll be able to establish a well understood and functional algorithm of monitoring and treatment. Material and methods: It has been studied 112 specialized literature sources that reflect the state of human tissues in some critical situations, including flaps. Results: Flap’s surgery is accompanied buy surgical trauma, and transfer of human tissues is followed by ischemic lesions of reperfusion, which can compromise the whole outcome of the interventions. It is recognized that the lesions of reperfusion is an inflammatory process, modulated by complex signaling mechanisms which eventually leads to cell death and flap’s damage. Restoring blood flow is essential for the flap’s survival; however, the paradox is that reperfusion produces an ischemic injury through numerous inflammatory pathways. Conclusions: Acute blockage of blood flow, without early detection and active treatment, soon is followed by systemic action in the form of polyorganic insufficiency and death

Decentralization and regional government size in Spain

The aim of this paper is to investigate the impact of fiscal decen- tralization on the size of regional governments in Spain, by controlling for economies of scale, interregional heterogeneity and institutional framework. We study it over 1985 to 2004 using a panel dataset of seventeen spanish regions. The results can be easily summarized. Firstly, it supports the classic public goods theory of a trade-off-between the economic benefits of size and the costs of heterogeneity. Secondly, it doesn’t reject the “Leviathan” hypoth- esis and neither does the “common pool” hypothesis. Thirdly, by contrast, the paper partly rejects the “Wallis”’ hypothesis. It argues that government size is mediated by financial resources obtained through intergovernmental grants, consistent with welfare economics and positive economic policies. We conclude that later advances in the decentralisation process must be compatible with the goal of reducing fiscal imbalances that emanate from the vertical structure of fiscal power.info:eu-repo/semantics/publishedVersio

Does Fiscal Decentralisation Foster Regional Investment in Productive Infrastructure?

The aim of this paper is to analyze the effect of revenue decentralization on the provision of infrastructure at the sub-national level. We estimate the effects of revenue decentralization and earmarked grant financing on the level of sub-national infrastructure investment in 20 European countries over the period 1990-2009. The results are interpreted in light of the predictions of the theory on fiscal federalism. We find that it is sub-national infrastructure investment that increases after revenue decentralization and not investment in redistribution. However, the effect of revenue decentralization is lower the higher the use of earmarked grants to fund infrastructure investment

Fiscal Decentralization and Regional Disparity: Evidence from Cross-Section and Panel Data

The advantages and disadvantages of public sector decentralization are widely discussed in economics and political science. Some authors argue that decentralization leads to an optimal provision of public services and promotes economic growth, while others emphasize the dangers of competition between sub-national governments, especially those associated with interregional redistribution. Using cross-section and panel data for 23 OECD countries from 1982 to 2000, this paper empirically studies the impact of fiscal decentralization on regional disparities. We find that a higher degree of decentralization is associated with lower regional disparities. Hence, poor regions experience no disadvantages from decentralization and instead appear to benefit

Federalism and Decentralization - A Critical Survey of Frequently Used Indicators

The economic effects of federalism are unclear: some papers find that federalism has strong positive effects on a number of economically relevant variables, others find negative effects. The results often crucially hinge upon the proxies for federalism used. In this paper, we critically survey the existing indicators for both federalism and fiscal decentralization. We argue that federalism is a constitutional institution whereas decentralization is (the outcome of) a policy choice and that the two ought to be systematically distinguished because decentralization can also occur in non-federally structured states. We further argue that institutional details are very important with regard to federalism and that dummy variables usually capture only very specific aspects of the institutional details. We use factor analysis to test whether the latent variables behind the observed indicators support these assumptions. It is shown that more than two important factors result, implying that a more fine-grained differentiation beyond the distinction between federalism and decentralization might be in order. The correlations of the most important proxies for various aspects of federalism and decentralization with a number of (quasi-) exogenous variables as well as with institutional variables are usually rather modest