Splenectomy through the laparoscopic approach and how I do it

Scopul lucrării. Studierea cazurilor de splenectomie prin abord laparoscopic și clasic în vederea stabilirii cauzalității tip procedurăincidente perioperatorii și demonstrării superiorității abordului laparoscopic. Materiale și metode. Au fost selectate cazurile de splenectomie efectuate prin abord clasic și laparoscopic în Clinica de Chirurgie Colțea, perioada 01.01.2019-31.12.2022. Am revăzut filmările intraoperatorii, am evaluat factorii generali și locali asociați abordului chirurgical preferat. Rezultate. Au fost selectate 29 de cazuri, vârsta medie 54.8 ani, 72.4% femei, 27.6% barbati, 55.2% (16) cu multiple comorbidități: antecedente chirurgicale majore, insuficiența cardiacă, asmul bronșic sever etc. Cazurile au fost împărțite în 2 grupe: Gr. I- cu abord laparoscopic 34.5% (10), Gr. II- cu abord clasic 65.5% (19). Incidența comorbidităților a fost de 10% (1) în Gr.I, cu dimensiunea medie a splinei de 13.2 cm (min 8.5 cm, max 21 cm) și 84.2 % (16) în Gr.II cu dimensiunea medie a splinei de 20.4 cm (min 10 cm, max 34 cm). Doar în Gr.II au fost înregistrate sângerări intraoperatorii în 78.9% (15), iar in 15.8% (3) au fost complicații postoperatorii. Pacienții din Gr.I au avut o perioadă de spitalizare postoperatorie medie de 4 zile, iar cei din Gr. II de 7 zile și au fost externați cu o evoluție postoperatorie favorabilă. Concluzie. Abordul laparoscopic are aceleași indicații ca abordul clasic conform EAES, cu avantajul complicațiilor perioperatorii mult reduse și o spitalizare postoperatorie mai mică comparativ cu abordul clasic, iar în cazul echipelor experimentate este posibil abordul laparoscopic inclusiv la pacienții cu splenomegalii masive (>20cm), care poate fi asistat manual.Aim of study. Study of cases of splenectomy by laparoscopic and classic approach in order to establish causality type procedureperioperative incidents and demonstrate the superiority of the laparoscopic approach. Materials and methods. The cases of splenectomy performed by classical and laparoscopic approach in the Colțea Surgery Clinic, period 01.01.2019-31.12.2022, were selected. We reviewed intraoperative films, assessed general and local factors associated with the preferred surgical approach. Results. 29 cases were selected, average age 54.8 years, 72.4% women, 27.6% men, 55.2% (16) with multiple comorbidities: major surgical antecedents, heart failure, severe bronchial asthma, etc. The cases were divided into 2 groups: Gr. I- with laparoscopic approach 34.5% (10), Gr. II- with classic approach 65.5% (19). The incidence of comorbidities was 10% (1) in Gr.I, with mean spleen size of 13.2 cm (min 8.5 cm, max 21 cm) and 84.2% (16) in Gr.II with mean spleen size of 20.4 cm (min 10 cm, max 34 cm). Only in Gr.II, intraoperative bleeding was recorded in 78.9% (15), and in 15.8% (3) there were postoperative complications. The patients in Gr. I had an average postoperative hospitalization period of 4 days, and those in Gr. II of 7 days, and were discharged with a favorable postoperative evolution. Conclusions. The laparoscopic approach has the same indications as the classic one according to EAES, with the advantage of reduced perioperative complications and a shorter postoperative hospitalization, and in the case of experienced teams, the laparoscopic approach is possible, including patients with massive splenomegaly (>20cm), being manually assisted

Assessment of the technological performance of some Saccharomyces and non-Saccharomyces indigenous yeast strains

The study aimed to assess the technological potential of four indigenous Saccharomyces cerevisiae strains (S. cer. 4.1.11, S. cer. 4.3, S. cer. 4.6 and S. cer. 4.10), as possible sources for starter cultures. The experiments were carried out at micropilot level on the natural must of 'Fetească albă' cultivar. The evaluation of the yeasts was carried out according to the chemical parameters and volatile compounds analysed in the obtained wines compared to the wine obtained with a commercial starter culture (CSC). The values of the main physico-chemical parameters analyzed in the obtained wines were similar to those determined in the control wine. The average values of the volatile compounds with positive impact on the wine aroma ranged within the interval 177.46 - 217.81 mg/L, a higher value compared to the control wine, respectively 166.33 mg/L. The use of the indigenous strain Torulospora delbrueckii (T.d 10) in association with the strains S. cer. 4.1.11 or S. cer. 4.10 led to an increase of 12.56%, respectively 8.30% in glycerol concentrations, as well as an increase of 11.94% to 14.49% in the average concentration of volatile compounds. Harnessing the oenological potential of the yeasts tested in sequential fermentations proved dependent on the time allowed for the development of the strain T.d 10, namely 24 and 48 hours, as well as on the yeasts used. Thus, in the wines obtained by the association T.d 10/ S. cer. 4.10, in which the development of the culture T.d 10 was carried out for 48 hours, we noticed an increase of 12.52% and, respectively 32.95%, in the average of volatile compounds, compared to the monoculture wine for the same S. cer. 4.10 strain and to the control wine (CSC)

Rheological properties of some complex polymers containing alicyclic structures

Paper presented at the 9th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Malta, 16-18 July, 2012.Two polyimides obtained from an alicyclic and flexible dianhydride, namely 5-(2,5-dioxotetrahydrofurfuryl)-3-methyl- 3-cyclohexene-1,2-dicarboxylic acid anhydride (DOCDA) and an aromatic diamines 4,4’-oxydianiline (ODA) or 4-(4-((4-(4- aminophenoxy) phenyl)sulfonyl)phenoxy (p-BAPS) were synthesized and analysed by rheological methods. The results were correlated with the chemical structure of polyimides and with other properties, such as flexibility, transparency, hydrophobicity and atomic force microscopy. It has been showed that the factors that contribute to the interactions in the polyimide systems can be controlled for improving the thermal, optical, and rheological properties, for subsequent microelectronic applications, in which relatively low permittivity and high thermal stability are required.dc201

Association phenomena in quaternized polysulfones/solvent/nonsolvent systems

Paper presented at the 9th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Malta, 16-18 July, 2012.Theoretical and experimental aspects on association phenomena generated by hydrogen bonding, dispersive and electrostatic interactions in ternary systems consisting of a proton-donor solvent (N,N-dimethylformamide or methanol), a proton-acceptor solvent (water), and a proton-acceptor polymer (polysulfone with different alkyl side chains), are investigated. In this context, binary and ternary thermodynamic interaction parameters are corrected on the basis of different association constants. Numerical values for these constants were evaluated as a function of the system composition, by mathematical simulations. As a result, mathematical simulations allow a good theoretical description of the preferential adsorption in agreement with experimental data.dc201

Влияние гиполипидемической длительной терапии на некоторые факторы риска пациентов со старым инфарктом миокарда и сахарным диабетом второго типа

Department of Chronic Heart Failure, Institute of Cardiology, 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 MoldovaScopul studiului. Determinarea influenţei tratamentului hipolipemiant de durată asupra unor factori de risc la bolnavii cu infarct miocardic vechi şi diabet zaharat tip 2. Material şi metode În studiu au fost incluşi 54 de pacienţi cu Q-Infarct miocardic vechi şi diabet zaharat tip 2 (vârsta medie de 58,88 ± 0,92 ani), dintre care 31 de bărbaţi şi 23 de femei. Pacienţii au fost divizaţi în 2 grupuri: I grup – pacienţi cu Q-Infarct miocardic vechi şi diabet zaharat tip 2, care au administrat tratament standard şi tratament hipolipemiant cu Lovastatină (doza medie – 33,15 mg/zi), timp de 1 an, şi al II grup – pacienţi cu Q-Infarct miocardic vechi şi diabet zaharat tip 2, care au administrat numai tratament standard. Corecţia glicemiei a fost efectuată cu Glibenclamid (doza medie – 7,7 mg/zi). La toţi pacienţii a fost efectuată lipidograma (cu determinarea colesterolului total, trigliceridelor, HDL-colesterolului, LDL-colesterolului), fibrinogenul, proteina C-reactivă şi aprecierea grosimii intima-media a arterei carotide, conform metodei propuse de Pignoli. Rezultate Pacienţii cu infarct miocardic vechi şi diabet zaharat tip 2 au valori înalte ale colesterolului total, trigliceridelor, LDLcolesterolului, proteinei C-reactive şi indicele intima-media. Administrarea tratamentului hipolipemiant de durată a redus nivelul colesterolului total cu 28,41% (p < 0,01), trigliceridelor - cu 17,96 % (p < 0,05), LDL-colesterolului - cu 31,49% (p < 0,001), proteina C-reactivă - cu 18,46% (p < 0,05), fibrinogen - cu 20,41% (p < 0,01) şi indicele intima-media - cu 13,91% (p < 0,05). Pe fundal de dietă hipolipemiantă a existat o tendinţă de majorare a nivelului proteinei C-reactive, a fibrinogenului şi indicelui intima-media, dar statistic nesemnificativ. Datele sunt prezentate în tabelul. 1. Concluzie Tratamentul hipolipemiant de durată este efectiv în reducerea factorilor de risc la bolnavii cu infarct miocardic vechi şi diabet zaharat tip 2

The safety and efficacy of systemic delivery of a new liver-de-targeted TGFβ signaling inhibiting adenovirus in an immunocompetent triple negative mouse mammary tumor model

Aberrant TGFβ signaling is linked to metastasis and tumor immune escape of many cancers including metastatic triple negative breast cancer (mTNBC). Previously, we have found that oncolytic adenoviruses expressing a TGFβ signaling inhibitory protein (sTGFβRIIFc) induced immune activation in a mouse TNBC (4T1) immunocompetent subcutaneous model with intratumoral injection. Systemic administration of adenoviruses can be a superior route to treat mTNBC but faces the challenges of increased toxicity and viral clearance. Thus, we created a liver-de-targeted sTGFβRIIFc- and LyP-1 peptide-expressing adenovirus (mHAdLyp.sT) with enhanced breast cancer cell tropism. Its safety and immune response features were profiled in the 4T1 model. Our data showed that the systemic administration of mHAdLyp.sT resulted in reduced hepatic and systemic toxicity. mHAdLyp.sT was also effective in increasing Th1 cytokines and anti-tumor cell populations by cytokine analysis, spleen/tumor qRT-PCR, and flow cytometry. We further tested the therapeutic effects of mHAdLyp.sT alone and in combination with immune checkpoint inhibitors (ICIs). mHAdLyp.sT alone and with all ICI combinations elicited significant inhibition of lung metastasis by histological analysis. When mHAdLyp.sT was combined with both anti-PD-1 and anti-CTLA-4 antibodies, primary 4T1 tumor growth was also significantly inhibited. We are confident in advancing this new treatment option for mTNBC

Global sensitivity analysis and optimal control of Typhoid fever transmission dynamics

This paper presents a mathematical model aimed at studying the global behaviour and optimal control strategies for Typhoid fever. The primary objective of this study is to identify the most effective control strategy that minimizes the spread of the disease. To achieve this, we calculate the effective and basic reproduction numbers and utilize them to investigate the existence and stability of the equilibria. Furthermore, we investigate the global impact of each model parameter on the variables using Latin Hypercube Sampling and Partial Rank Correlation Coefficient. The necessary conditions of the optimal control problem are analyzed using Pontryagin’s maximum principle, and the numerical values of the model parameters are estimated using the maximum likelihood estimator. The results indicate that the optimal use of vaccination for susceptible individuals, as well as the screening and treatment of asymptomatic infected individuals, have a significant impact on reducing the spread of the disease in endemic regions

Исследование качества жизни у больных с хронической сердечной недостаточностью ишемического происхождения с систолической дисфункцией или с сохраненной функцией левого желудочка

Institute of Cardiology, Department of Chronic Heart Failure, 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 MoldovaThe aim of this study was to determine changes in quality of life in patients with chronic HF in relation to the degree of LV systolic dysfunction and NYHA functional class. The study included 337 patients with ischemic heart failure, functional class NYHA II and III. All patients included were Romanian-speaking. To determine the quality of life in the study population, three questionnaires were used (validated version in Romanian): Minnesota Living with Heart Failure Questionnaire (Minnesota LHF Q), Mac New Heart Disease HRQL questionnaire and MOS-SF-36 questionnaire, short form. It Significant differences in quality of life between groups of patients with NYHA functional class II and III were identified after the application of all three questionnaires. In groups of patients with and without LV systolic dysfunction, application of Minnesota and MacNew questionnaires did not determine significant differences between groups in quality of life indices. And, the application of the generic SF-36 questionnaire has highlighted that physical functioning and pain indices and total physical component were more favorable in patients without LV systolic dysfunction. Thus, differences of quality of life were more evident in groups of patients divided according NYHA functional class than in groups of patients with or without LV systolic dysfunction.Целью исследования было в определении качества жизни у пациентов с хронической сердечной недостаточностью (ХСН) в зависимости от степени систолической дисфункции левого желудочка и функционального класса (ФК) NYHA. В исследование было включено 337 пациентов с сердечной недостаточностью (ФК II - III NYHA) ишемического происхождения. Для определения качества жизни были использованы 3 опросника (Minnesota LHF Q, MacNew Heart Disease HRQL и MOS SF-36). Статистически достоверные различия качества жизни были определены при использовании 3 опросников в группах больных разделенных в зависимости от ФК NYHA. При использовании опросников Minnesota LHF Q и MacNew, достоверные различия качества жизни в группах с нормальной функцией ЛЖ и с систолической дисфункцией ЛЖ не были определены. При применении вопросника SF-36 было установлено, что физическое функционирование, индекс боли и общий физический компонент были более благоприятными в группе пациентов с сохраненной функцией ЛЖ. Таким образом, различия в качестве жизни были более очевидны в группе больных, разделенных в зависимости от ФК NYHA, чем в группах больных с систолической дисфункцией ЛЖ или без нее

Исследование психометрических качеств опросников Minnesota LHF Q, MacNew Heart Disease HRQL и MOS SF-36 у больных с хронической сердечной недостаточностью ишемического происхождения

Department of Chronic Heart Failure, Institute of Cardiology, State University of Medicine and Pharmacy „Nicolae Testemitanu”, Chisinau, Republic of MoldovaUntil now there have not been validated instruments that assess the quality of life in patients with cardiovascular disease in the Republic of Moldova. The 6 stages of Minnesota LHF Q, MacNew Heart Disease HRQL and MOS SF-36 questionnaires were validated, followed by a pilot study – 337 patients with ischemic chronic heart failure in II-III NYHA functional classes. To determine the psychometric qualities of the questionnaires we performed a test-retest method looking at correlations between the components of the questionnaires and quality of life indices, which were analyzed according to the age, sex, living environment, and studies. Our results demonstrated the questionnaires’ reliability and validity through the indication of linguistic validation that had been carried out successfully. Thus, it can be a methodological basis for future clinical trials in the Republic of Moldova.В настоящее время в Республике Молдова инструменты для оценки качества жизни пациентов с сердечно-сосудистой патологией не валидированы. Нами были выполнены все 6 этапов валидации трёх опросников (Minnesota LHF Q, MacNew Heart Disease HRQL и MOS SF36), с последующим проведением пилотного исследования – 337 пациентов с сердечной недостаточностью (ФК II-III NYHA) ишемического происхождения. Чтобы определить психометрические качества опросников было проведено двойное тестирование пациентов, корреляции между компонентами опросников, были проанализированы параметры качества жизни в зависимости от возраста, пола, условий жизни, наличия высшего образования. Полученные результаты продемонстрировали надежность и валидность опросников. Таким образом, проведение данной валидации составит методологическую основу для последующего проведения в нашей стране сравнимых клинических исследований в области кардиологии

Сравнительная оценка структуры заболеваемости студентов I курса Государственного Медицинского и Фармацевтического Университета им. Н. A. Тестемицану

Department of Family Medicine and Laboratory of Genetics, Nicolae Testemiţanu State Medical and Pharmaceutical University, Chisinau, Republic of Moldova, 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 MoldovaThe purpose of this work was to comparatively evaluate the morbidity spectrum of the first year students of the SMPhU ”Nicolae Testemiţanu” enrolled in 2002-2004 and 2010-2011. Materials and methods: the data of medical examination performed at the University Clinic of Primary Care were analyzed in order to estimate the morbidity spectra. Results: the comparative analysis of the health status of students revealed an increase of students being “sick” from 24.0% in 2002-2004 to 35.0% in 2010-2011. The comparative analysis of morbidity spectra denotes a significant increase in proportions of eye pathology, pathologies of urinary and digestive tracts and endocrine system in the morbidity structure during 2002-2011 period. Conclusions: our data support the need of medical examination of first-year students in order to identify the existing chronic pathologies, proper treatment, and monitoring their diseases during the academic years.Целью настоящей работы была сравнительная оценка структуры заболеваемости студентов первого курса Государственного Медицинского и Фармацевтического Университета имени „Николая Тестемицану”, поступивших на учебу в 2002-2004 и 2010-2011 годы. Материал и методы: результаты медицинского осмотра студентов первого курса 2002-2004 и 2010-2011 годов поступления, для определения спектра заболеваемости. Результаты: сравнительный анализ состояния здоровья студентов показал увеличение группы студентов «больных» от 24,0% в 2002-2004 гг. до 35,0% в 2010-2011 гг. В структуре заболеваемости за период 2002-2011 годы произошло значительное увеличение доли глазной патологии, патологии мочеполового, пищеварительного трактов и эндокринной системы. Выводы: Для выявления существующих хронических заболеваний, своевременного их лечения и мониторинга динамики состояния здоровья студентов во время учебы, необходимо проведение медицинского осмотра студентов на первом курсе